Deskripsi Pekerjaan
We are seeking a detail-oriented and experienced Insurance Authorization Specialist to join our team. This is a fully remote work-from-home opportunity, allowing you to work from the comfort of your home in Metro Manila. As an Insurance Authorization Specialist, you will play a critical role in ensuring that patients receive timely access to necessary medical services by verifying insurance coverage and obtaining prior authorizations from insurance providers.
In this role, you will be responsible for communicating with healthcare providers, insurance companies, and patients to gather and submit required documentation. You will need to stay updated on insurance policies, medical necessity guidelines, and regulatory requirements to ensure compliance. Your attention to detail and ability to navigate complex authorization processes will contribute to a smooth and efficient revenue cycle.
If you have a strong background in insurance verification and authorization, excellent communication skills, and a dedication to providing high-quality support, we encourage you to apply. Join our growing team and enjoy a flexible work schedule, competitive salary, and the opportunity to grow your career in a supportive environment.
Tanggung Jawab
- Verify patient insurance coverage and eligibility for medical services and procedures.
- Obtain prior authorizations and referrals from insurance companies and healthcare providers.
- Communicate with physicians, clinics, and insurance representatives to gather necessary documentation and resolve authorization issues.
- Accurately document all authorization requests and outcomes in the system.
- Monitor and follow up on pending authorization requests to ensure timely approvals.
- Maintain up-to-date knowledge of insurance plan requirements, medical policies, and coding guidelines.
- Collaborate with billing and coding teams to ensure proper claim submission and minimize denials.
- Provide exceptional customer service to patients and healthcare providers regarding authorization status and requirements.
Kualifikasi
- High school diploma or equivalent; associate or bachelor's degree in healthcare administration or related field preferred.
- Minimum of 1-2 years of experience in insurance authorization, medical billing, or a similar role.
- Knowledge of medical terminology, CPT/HCPCS codes, and ICD-10 coding.
- Familiarity with insurance verification portals and electronic medical records (EMR) systems.
- Excellent communication and interpersonal skills, both written and verbal.
- Strong attention to detail and ability to multitask in a fast-paced environment.
- Proficiency in Microsoft Office applications (Word, Excel, Outlook).
- Ability to work independently and manage time effectively in a remote work setting.