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Prior Authorization Consultant | Work from Home

Key Facts

Remote From: 
Freelance
English

Other Skills

  • •
    Non-Verbal Communication
  • •
    Communication
  • •
    Multitasking
  • •
    Time Management
  • •
    Detail Oriented
  • •
    Prioritization

Roles & Responsibilities

  • Bachelor's degree (preferably in Medical, but not required)
  • Minimum 6 months consultancy contract experience (subject to renewal)
  • At least 1 year of Prior Authorization experience under a BPO healthcare account (advantage)
  • Excellent English communication skills, both written and oral

Requirements:

  • Receive and monitor prior authorization requests via the EHR Scheduling module and via phone or fax
  • Process referrals and submit medical records to insurance carriers to expedite prior authorization processes
  • Review patient medical history and insurance coverage for approval
  • Manage correspondence with insurance companies, physicians, specialists, and patients; document in the EHR and perform necessary follow-up to expedite approvals

Job description

Salary: 30,000 PHP- 35,000/ month

Job Description:

  • Receive requests for prior authorizations using the Scheduling module of the Electronic Health Record (EHR) and/or via phone or fax and ensure that they are closely monitored.
  • Process referrals and submit medical records to insurance carriers to expedite prior authorization processes.
  • Review the patient's medical history and insurance coverage for approval.
  • Manage correspondence with insurance companies, physicians, specialists, and patients as needed, including documenting in the EHR as appropriate.
  • Assist with the necessary documentation to expedite approvals and ensure that appropriate follow-up is performed.
  • Review the accuracy and completeness of the information requested and ensure that all supporting documents are present.

Minimum Qualifications:

  • Graduate of Bachelor's Degree (preferably in Medical, but not required)
  • Consultancy basis minimum of 6 months consultancy contract (subject for renewal)
    • At least 1 year of background with Prior Authorization under a BPO healthcare account is an advantage
    • Must have excellent English communication skills, both written and oral
    • Ability to prioritize and organize multiple tasks
    • Willing to work in shifting schedules, mostly night shift
    • Able to Work From Home, must have a reliable internet connection

    Others:

    • Equipment/ company computer is provided
    • Work from Home

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