Key Facts

Remote From:

Full time

English

Hard Skills

Medical Record Management Prior Authorization Electronic Health Record Applications Data Quality Assessment Insurance Reviews Policy Enforcement Fax Servers Organizational Structure Basic Patient Care

Other Skills

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Communication
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Multitasking
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Detail Oriented
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Prioritization

Roles & Responsibilities

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 prior authorization experience under a BPO healthcare account (advantage).
Excellent English communication skills (written and oral); ability to prioritize and organize multiple tasks; strong customer-centric approach; willing to work in shifting/night shifts; able to work from home with reliable internet.

Requirements:

Receive and monitor requests for prior authorizations via the EHR Scheduling Module, 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, including EHR documentation.
Verify information accuracy and completeness; ensure all supporting documents are present; assist with documentation to expedite approvals and follow-up.

Vector Outsourcing Solutions Philippines

About Vector Outsourcing Solutions Philippines

At Vector Outsourcing Solutions Phils. Inc, our mission is to establish ourselves as the ‘Best in Class’, in the delivery of healthcare management services and billing services. We handle each and every client as if they are our only client by providing individualized business plans and keeping the client informed of the ever changing healthcare industry. Our attentiveness to your billing, your practice needs and your path to success will exceed all expectations. We believe that our success can only be measured through the success of the medical practices we manage.We are fast growing US based healthcare BPO supporting medical groups, dental groups, diagnostic laboratories, urgent care centers and other ancillary health care providers. Join us now and end up on top as we continue to expand.Vision:To improve healthcare delivery by placing the needs of both providers and patients at the forefront and delivering exceptional customer serviceMission:To provide world class customer service, that drives efficiency and progress within the healthcare system, by working together in a culture of continuous improvement and innovationValues:TransparencyHonestyAccountabilityTrustResponsibilityEfficiencyAdaptabilityInnovationRespect

Company type: SME

Founded: 2018

Company size: 51 - 200

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Job description

Salary: 30,000- 50,000 PHP/ 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.
Follow team and/or client's proper procedures, policies, and methodologies as instructed.
Performs other related duties as necessary or assigned

Eligibility and Benefits Verification:

Verify insurance eligibility for new and established patients by contacting insurance companies and using online verification systems.
Review insurance plans to ensure proper coverage for Senior/Elder Care (e.g., wellness visits, screenings, and vaccinations).
Confirm patient benefits, co-pays, deductibles, and any specific requirements or limitations for Senior Care.
Provide patients with detailed information regarding their coverage, including potential out-of-pocket costs.

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
Strong communication skills and customer centric
Willing to work in shifting schedules, mostly night shift
Able to work from home, must have a reliable internet connection

Others: