Insurance Verification and Authorization (IV/Auth) Auditor

Discover your 100% YOU with MicroSourcing!

Position: Insurance Verification and Authorization (IV/Auth) Auditor
Location: Taguig
Work setup & shift: Onsite | Night shift

Why join MicroSourcing

Youu0027ll have:

• Competitive Rewards: Enjoy above-market compensation, healthcare coverage on day one, plus one or more dependents, paid time-off with cash conversion, group life insurance, and performance bonuses
• A Collaborative Spirit: Contribute to a positive and engaging work environment by participating in company-sponsored events and activities.
• Work-Life Harmony: Enjoy the balance between work and life that suits you with flexible work arrangements.
• Career Growth: Take advantage of opportunities for continuous learning and career advancement.
• Inclusive Teamwork: Be part of a team that celebrates diversity and fosters an inclusive culture.

Your Role
As an IV/Auth Auditor, you will:

POSITION SUMMARY:

The Insurance Verification and Authorization (IV/Auth) Auditor will be responsible for the auditing of insurance verification and authorization tasks to ensure performance standards are met. This role requires frequent and effective communication via phone, email, and instant messaging with various client teams.

IV/Auth Auditing:

• Responsible for the auditing of IV/Auth specialist and/or audit the auditors to ensure IV/ accuracy expectations are met
• Perform quality checks/audits on visits worked by IV/Auth Specialist as per client SOPs.
• Perform calibration audits.

IV/Auth Audit Reporting:

• Suggest improvements and schedule calibration sessions with offshore team counterparts and leaders.
• Assist in preparing audit reports, share direct feedback to IV/Auth specialists and auditors on areas of opportunity, participate in client interactions and internal stakeholder meetings.
• Firm understanding of insurance verification and authorization processes
• Monitor compliance of IV/auth guidelines and ensure errors identified during audits are corrected as appropriate, and corrective action is initiated before the claim is rebilled to the insurance.
• Conduct analysis and present summary of findings to leadership in a clear, concise, convincing, and actionable format.
• Immediately escalates any compliance risks or issues to leadership.

Other duties and responsibilities as assigned.

About the Client - Huron

Huron helps its clients drive growth, enhance performance, and sustain leadership in the markets they serve. We help healthcare organizations build innovation capabilities and accelerate key growth initiatives, enabling organizations to own the future, instead of being disrupted by it. Together, we empower clients to create sustainable growth, optimize internal processes, and deliver better consumer outcomes.

Health systems, hospitals, and medical clinics are under immense pressure to improve clinical outcomes and reduce the cost of providing patient care. Investing in new partnerships, clinical services, and technology is not enough to create meaningful and substantive change. To succeed in the long term, healthcare organizations must empower leaders, clinicians, employees, affiliates and communities to build cultures that foster innovation to achieve the best outcomes for patients.

Joining the Huron team means you'll help our clients evolve and adapt to the rapidly changing healthcare environment and optimize existing business operations, improve clinical outcomes, create a more consumer-centric healthcare experience, and drive physician, patient and employee engagement across the enterprise.

What You Need
Non-negotiables

• Experience: One year of IV/Auth auditing experience
• Education: Senior High School Diploma or equivalent
• RCM Knowledge: Knowledge of insurance verification and authorization processes. Familiarity with HIPAA regulations.
• Software Knowledge: Proficiency with electronic medical records (EMR) such as Epic, Cerner, or Meditech.
• Excellent verbal and written English communication skills and customer service skills (CEFR level of at least B2 for both verbal and written)

Soft Skills:

• Ability to pay close attention to details strong follow-up and follow-through skills
• Regularly makes complex decisions within the scope of the position, and is comfortable working independently
• Independent judgment, discretion and decision-making abilities
• Demonstrates teamwork and integrity in all work-related activities
• Ability to interact with internal and external customers in a professional manner
• Strong analytical and critical thinking skills
• Safeguard patient health information in compliance with HIPAA standards
• Knows, understands, incorporates, and demonstrates Huron's Vision, and Values in behaviors, practices, and decisions

Preferred Qualifications:

• Experience: At least three years IV/Auth experience.
• Education: Bachelor in business or health field
• Software Knowledge: Proficiency with Microsoft office suite (Excel, Word, PowerPoint, Outlook, SharePoint) . Proficiency with Microsoft office suite (Excel, Word, PowerPoint, Outlook, SharePoint)
• RCM Knowledge: Prior experience with US healthcare providers or payers.

IV Auth Auditor Specialist Key Performance Indicators (KPIs) - Expectations

• Timely completion of audits with feedback and action plans
• Maintains quality standards for QA work

About MicroSourcing
With over 9,000 professionals across 13 delivery centers, MicroSourcing is the pioneer and largest offshore provider of managed services in the Philippines.

Our commitment to 100% YOU
MicroSourcing firmly believes that our companyu0027s strength lies in our peopleu0027s diversity and talent. We foster an inclusive culture that embraces individuals of all races, genders, ethnicities, abilities, and backgrounds.

At MicroSourcing, equality is not merely a slogan - itu0027s our commitment. Our way of life. Here, we donu0027t just accept your unique authentic self - we celebrate it, valuing every individualu0027s contribution to our collective success and growth. Join us in celebrating YOU and your 100%!

For more information, visit https://www.microsourcing.com/
Terms & conditions apply.