US Healthcare - Pre-authorization - Cebu Onsite

Tahche Outsourcing Services Inc; Cebu City; On-site; PHP 201,000 - 335,000; Full time

Job summary

The ideal candidate has 6+ months of pre-authorization experience, knowledge of CPT and DX codes, familiarity with insurance portals, and strong communication. College-level study in Life Sciences or related fields is preferred.

Qualifications

• 6+ months of healthcare pre-authorization experience
• Knowledge of CPT and DX codes
• Familiarity with insurance portals
• Strong communication and attention to detail
• At least 2nd-year college level in Life Sciences or related field

Responsibilities

• Process pre-certifications and pre-authorizations for radiology procedures
• Verify insurance, referrals, and authorization requirements
• Create and manage cases through eviCore and insurance portals
• Review clinical documentation and follow up on pending/denied cases
• Monitor radiology worklists and prioritize cases accordingly

Skills

Healthcare Pre-Authorization

CPT/DX codes

Insurance portals

Communication

Attention to detail

Education

2nd-year college level in Life Sciences or related field

Job description

Job Description

What You’ll Do

• Process pre-certifications and pre-authorizations for radiology procedures
• Verify insurance, referrals, and authorization requirements
• Create and manage cases through eviCore and insurance portals
• Review clinical documentation and follow up on pending/denied cases
• Monitor radiology worklists and prioritize cases accordingly

Job Qualifications

What We’re Looking For

• 6+ months of Healthcare Pre-Authorization/Pre-Certification experience
• Knowledge of CPT and DX codes
• Familiarity with insurance portals
• Strong communication and attention to detail
• At least 2nd-year college level in Life Sciences or related field