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:
- Equipment/ company computer is provided
- Work from Home
