Prior Authorization/Authorization CSRs (Home Health and Care Exp. Preferred) - #87892

GeBBS Healthcare Solutions is URGENTLY hiring Prior Authorization CSRs for a US Healthcare account. Candidates with home care or home health experience are preferred. Successful hires can start ASAP. For interested applicants and referrals, you may either visit one of our offices from Mondays to Fridays between 7 PM to 11 PM or send your updated resumes to:

adrian.castellano(at sign)gebbs.com – For our Ortigas site

jeaselrea.galido(at sign)gebbs.com – For our Eastwood site

allyzajean.cimafranca(at sign)gebbs.com – For our Mandaluyong site

shylasolleen.sasis(at sign)gebbs.com – For our MOA site

GeBBS Healthcare Solutions sites:

Eastwood, Quezon City (IBM Plaza Building)

Ortigas, Pasig City (Antel Global Corporate Center)

Mandaluyong (Pioneer Highlands Tower 2)

MOA (Ground Floor, One E-Com Center)

• One-day recruitment process
• Virtual process for some accounts but onsite candidates are prioritized
• Fresh graduate friendly accounts
• Start ASAP
• HMO coverage
• Yearly Appraisal
• Fixed Weekends Off

Key Responsibilities:

Verify Insurance Eligibility and Benefits: Examine and confirm patients' insurance coverage, benefits, and medical care requirements.

Obtain Pre-Authorization: Request, track, and secure pre-authorization from insurance carriers for medical treatments and services within specified deadlines.

Handle Correspondence: As needed, communicate with insurance companies, physicians, specialists, and patients. Enter pertinent information into the Electronic Health Record (EHR).

Help with Medical Necessity Documentation: Work with healthcare professionals to speed up approvals by establishing medical necessity. Ascertain that necessary follow-up activities are taken.

Review and Appeal rejections: When medical necessity is proven, review insurance rejections and collaborate with healthcare providers to acquire the information needed to appeal denials.

Prioritize Authorizations: To promote efficient processing, organize incoming authorizations based on their level of urgency.

Job Qualifications

• Home health or home care and EPIC experience is preferred but not required
• Open to graduates and undergraduates of any Medical Allied Course (fresh graduates are welcome to apply)
• Candidates with 1 year of work experience in healthcare, back office, or transaction processing will be prioritized.
• Background with Prior Authorization or Clinical Review under a BPO healthcare account is an advantage but not required
• Can start ASAP and open to work onsite in the following sites (Ortigas, Eastwood, Mandaluyong, or MOA)