Healthcare Authorization Specialist
S
SourcefitHealthcare Administration
Work from Home, 9:00 PM to 6:00 AM Manila TimeFull-Time
Salary not disclosed
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Job Details
- Required Skills
- Microsoft OfficeEHR
Requirements
- Experience in healthcare prior authorization, insurance verification, medical billing, revenue cycle, or a related healthcare administrative role is preferred.
- Strong understanding of insurance eligibility verification, prior authorization processes, and healthcare payer requirements.
- Familiarity with medical terminology.
- Experience navigating insurance payer websites and online portals.
- Excellent verbal and written communication skills, with the ability to interact professionally with insurance representatives and internal teams.
- Strong attention to detail and a high level of accuracy when handling patient and insurance information.
- Strong analytical and problem-solving skills.
- Excellent organizational and time management skills, with the ability to prioritize tasks in a fast-paced environment.
- Ability to work independently while managing multiple authorization requests and meeting strict turnaround times.
- Proficiency in Microsoft Office applications and healthcare information systems or electronic medical records (EMR/EHR) is an advantage.
- Ability to perform effectively in a time-sensitive environment.
Responsibilities
- Verify patient insurance eligibility, benefits, and coverage prior to treatment or service.
- Secure prior authorizations from insurance companies for scheduled medical services and treatments.
- Complete and submit authorization requests accurately and within required turnaround times.
- Communicate with insurance providers via phone and payer portals to obtain authorization approvals and verify coverage details.
- Coordinate with internal clinical and administrative teams regarding authorization status and any additional documentation requirements.
- Maintain accurate and up-to-date records of insurance verifications, authorizations, approvals, denials, and follow-up activities.
- Monitor pending authorization requests and proactively follow up to prevent delays in patient care.
- Review payer requirements and ensure all submitted documentation meets insurance guidelines.
- Escalate authorization issues or delays to the appropriate internal stakeholders when necessary.
- Ensure compliance with patient confidentiality requirements and applicable healthcare regulations.
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