Prior Authorization Specialist

HR TechX Corp.


Date: 2 weeks ago
City: Pasig City
Contract type: Full time
Qualifications:

  • Bachelor's degree in any allied medical course
  • At least 6 months of experience in prior authorization
  • Strong communication skills, both verbal and written
  • Willing to work onsite


Job Description:

  • Contacting insurance companies to request prior authorization for specific medical procedures or prescriptions.
  • Verifying Information: Checking patient eligibility, benefits, and coverage with insurance companies.
  • Documenting Interactions: Keeping detailed records of all communications with insurance companies and patients.
  • Managing Denials: Investigating denials, resubmitting requests, and potentially appealing decisions to ensure patient access to necessary care.
  • Communicating with Patients: Explaining the prior authorization process to patients, including potential delays and financial implications.
  • Collaborating with Providers: Working closely with healthcare providers to collect necessary clinical information for authorization requests.

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