Healthcare Prior Authorization_Up to 40K Ortigas

Job Overview

We are seeking a detail-oriented and motivated Prior Authorization Specialist with a background in the medical allied field. The successful candidate will be responsible for handling prior authorization requests, ensuring accuracy and compliance with payer requirements, and supporting healthcare providers in securing approvals for medical services and procedures.

Key Responsibilities

• Process and manage prior authorization requests for medical services, procedures, and medications.
• Review clinical documentation and ensure compliance with payer guidelines and requirements.
• Communicate with healthcare providers, insurance companies, and patients to facilitate approvals.
• Track, follow up, and resolve pending authorizations in a timely manner.
• Document all activities accurately within the system for auditing and compliance purposes.
• Collaborate with internal teams to ensure smooth workflow and process efficiency.