Job Description
About Visaya KPO
Visaya Knowledge Process Outsourcing Corporation is a proudly Filipino organization recognized globally for service excellence, innovation, and a culture of malasakit. We are committed to building long-term partnerships through quality, reliability, and a people-first approach.
Role Overview
We are looking for a detail-oriented Prior Authorization Specialist to join our team. The ideal candidate will have experience in medical coding within the US healthcare system, whether certified or non-certified, and a strong background in medical management resolution.
Key Responsibilities
Review and analyze medical records, claims, and documentation to resolve medical management and coding issues.
Collaborate with healthcare providers, coders, and payers to clarify documentation and ensure accurate coding and claim resolution.
Assist in resolving denials, discrepancies, and other issues related to medical management and billing.
Maintain detailed records of case resolutions and communicate updates to relevant stakeholders.
Support process improvement initiatives to enhance accuracy and efficiency in medical management resolution.
Stay current with coding guidelines, payer policies, and healthcare regulations.
Ensure compliance with company policies and regulatory standards.
Qualifications
College level education.
Minimum of 2 years related experience in medical management resolution or prior authorization
Preferably with a strong understanding of medical coding systems and healthcare terminology.
Excellent problem-solving, communication, and analytical skills.
Willingness to work onsite in Ortigas and on a night shift schedule.
Detail-oriented with the ability to manage multiple cases efficiently.
Perks And Benefits
15% Night Differential
HMO coverage after 30 days of employment (with option to add up to 2 dependents)
Retirement Benefits
24 Leave Credits per year (convertible to cash)
Wholistic Employee Wellness Program
Why Join Visaya KPO
Be part of a multi-awarded, 100% Filipino-owned company recognized for its leadership and innovation in the outsourcing industry. Work in a culture that values professional growth, employee well-being, and long-term partnerships. Enjoy industry-leading benefits and a supportive, inclusive environment
