Job Openings Healthcare Customer Service Representative

About the job Healthcare Customer Service Representative

We are seeking a detail-oriented and compassionate Customer Service Representative (CSR) to join our Healthcare team, specifically supporting prior authorization services. In this role, you will assist patients, providers, and pharmacy professionals by verifying benefits, explaining coverage, and facilitating prior authorization requests for healthcare services and medications.

Qualifications:

  • Must be College graduate in any Medical Allied course
  • 6 months experience in healthcare
  • Preferably with prior authorization experience.
  • Good to excellent comms skills.
  • Can start ASAP.

Responsibilities:

  • Handle end-to-end prior authorization requests for healthcare services or medications
  • Verify patient insurance eligibility and coverage details
  • Review and collect required clinical documentation for submission
  • Submit PA requests to insurance payers via portal, fax, or phone
  • Track and follow up on submitted authorizations to ensure timely processing
  • Communicate authorization status, approvals, or denials to providers and patients
  • Assist with appeals and additional documentation requests when needed
  • Maintain accurate records in system and ensure HIPAA compliance


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