Insurance Verification and Authorization (IV/Auth) Specialist

Discover your 100% YOU with MicroSourcing!

Position: Insurance Verification and Authorization (IV/Auth) Specialist
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 Specialist, you will:
IV/Auth Assignment

• Insurance Verification: Verify insurance and benefit eligibility for patient services.
• Authorization:
  • Review clinical documentation and insurance guidelines to determine authorization requirements.
  • Verify authorizations obtained by provider offices are accurate, including CPT code, patient demographics, and effective dates.
  • Obtain prior authorizations for scheduled services as necessary to secure financial coverage.
  • Ensure timely submission and follow-up of prior authorization requests to meet turnaround time expectations.
  • Identify and escalate authorization denials or delays to the appropriate team (e.g., Patient Access, Billing).
  • Notify admissions as required by payers and review medical necessity criteria as needed.

Payer and Patient Communication

• Perform outbound calls and online inquiries to insurance companies, providers, and patients to verify eligibility and follow up on authorization requests.
• Handle inbound calls from U.S.-based patients and providers with empathy and professionalism.
• Coordinate with physician offices and clinical teams to obtain missing documentation.

Documentation & Compliance

• Accurately enter and update authorization, eligibility, benefit, and patient demographic details in EMR systems (e.g., Epic, Cerner, Meditech).
• Document all payer communications and account activity according to standards.
• Maintain confidentiality, professionalism, and compliance with HIPAA and other regulatory standards.
• Adhere to IV/Auth quality and productivity standards established by the organization.
• Perform other duties and responsibilities as assigned.

What You Need
Non-negotiables

• Experience: Minimum of 1 year in US healthcare insurance verification and authorization.
• Education: Senior High School Diploma or equivalent.
• Software Knowledge: Experience with EMR systems (Epic, Cerner, Meditech).
• Strong understanding of insurance verification processes, benefit determination, and payer portals.
• Proficiency in Microsoft Office tools (Word, Excel, Outlook).
• Excellent verbal and written English communication skills (CEFR B2 minimum).
• Willingness to work night shifts aligned with US time zones.

Preferred skills/expertise

• Authorization experience: 2+ years in US healthcare insurance verification and authorization.
• Philippine bacheloru0027s degree or equivalent preferred.
• Knowledge of CPT and ICD-10 coding.
• Ability to prioritize amid competing tasks.
• Strong analytical, critical thinking, and problem-solving skills.
• Attention to detail with strong follow-up and follow-through skills.
• Independent judgment, discretion, and decision-making abilities.
• Demonstrates teamwork, integrity, and professional communication.
• Incorporates Huronu0027s vision and values into work practices

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.