Insurance Verification and Authorization (IV/Auth) Specialist

Job Title: Insurance Verification and Authorization (IV/Auth) Specialist Huron Target Start Date: May 4, 2026 (4 FTEs) Huron Sign On Bonus: Not applicable (Reconfirm with Huron/CI) Huron JD notes per email thread: Huron PH Job Descriptions (Updated) – sent by Dexter DCosta, 25 December 2026 12/24/25 DD: Reviewed and finalised - added date to file name. External Job Title: Insurance Verification and Authorization (IV/Auth) Specialist Capability: Healthcare Business Unit: Huron Managed Services Level: Reports To: Supervisor/Manager/Director, Authorization Work Location: Microsourcing Office, Taguig, Philippines Work Shift: PH Night POSITION SUMMARY: Huron helps its clients drive growth, enhance performance, and sustain leadership in the markets they serve. We help healthcare organizations build innovation capabilities and accelerate key growth initiatives, enabling organizations to own the future, instead of being disrupted by it. Together, we empower clients to create sustainable growth, optimize internal processes, and deliver better consumer outcomes. Health systems, hospitals, and medical clinics are under immense pressure to improve clinical outcomes and reduce the cost of providing patient care. Investing in new partnerships, clinical services, and technology is not enough to create meaningful and substantive change. To succeed in the long-term, healthcare organizations must empower leaders, clinicians, employees, affiliates, and communities to build cultures that foster innovation to achieve the best outcomes for patients. Joining the Huron team means you will help our clients evolve and adapt to the rapidly changing healthcare environment and optimize existing business operations, improve clinical outcomes, create a more consumer-centric healthcare experience, and drive physician, patient, and employee engagement across the enterprise. Excellent communication skills, attention to detail, and strong analytical and problem-solving abilities are essential for success in this role. KEY RESPONSIBILITES: Insurance Verification Verify insurance and benefit eligibility for patient services Authorization Review clinical documentation and insurance guidelines to determine authorization requirements May be responsible for verifying authorizations obtained by provider offices are accurate including correct CPT code, patient demographics, and effective dates cover the scheduled service date May be responsible for obtaining authorizations for scheduled services from insurance or third parties as necessary to financially secure services Ensure timely submission and follow-up of prior authorization requests to meet turnaround time (TAT) expectations Identify and escalate authorization denials or delays in authorization to the appropriate team (e.g., Patient Access, Billing, etc.) May be responsible for notification of admission as required by payers May need to review medical necessity criteria and payer-specific guidelines Payer and Patient outreach and communication Perform outbound calls and online inquiries to insurance companies, providers, and patients to verify eligibility and to initiate and follow up on prior authorization requests Handle inbound calls from U.S.-based and providers, demonstrating effective communication skills, empathy, and familiarity with healthcare or revenue cycle management processes Coordinate with physician offices and clinical teams to obtain missing documentation Documentation Accurately enter and update authorization, eligibility, benefit, and patient demographic details in the client system (e.g., Epic, Meditech, Cerner) Documents all payer communication and account activity according to defined standards Maintain high level of confidentiality, professionalism, and compliance with HIPAA and other regulatory standards to protect patient information Adhere to the IV/Auth quality and productivity standards established by the organization Other duties and responsibilities as assigned. QUALIFICATIONS: Insurance Verification/Authorization Experience: At least one year of US Healthcare industry experience completing insurance verification and authorization activities Education: Senior High School Diploma Software Knowledge: Experience with an electronic medical record (EMR) system (e.g., Epic, Cerner, Meditech, etc.) Strong understanding of insurance verification processes and benefit determination Familiarity with payer portals and insurance websites for checking authorization and eligibility status Proficiency in MS Office Standard Tools (Word, Outlook, Excel, etc.) Soft Skills Demonstrated ability to prioritize amid competing priorities Strong ability to analyze raw data, draw conclusions, and develop actionable recommendations Proven ability to adapt quickly to new and changing technical environments Ability to pay close attention to details; strong follow-up and follow-through skills Regularly makes complex decisions within the scope of the position, and is comfortable working independently Independent judgment, discretion, and decision-making abilities Demonstrates teamwork and integrity in all work-related activities Ability to interact with internal and external customers in a professional manner Strong analytical and critical thinking skills Knows, understands, incorporates, and demonstrates Huron’s Vision, and Values in behaviors, practices, and decisions Authorization Experience: Two or more years of US Healthcare industry experience completing insurance verification and authorization activities Education: Philippine bachelor’s degree or equivalent preferred RCM Knowledge: Knowledge of CPT and ICD-10 coding IV/Auth Key Performance Indicators (KPIs) - Expectations Meets 100% of productivity standards, as defined by the organization (e.g., completed and documented work on 40 accounts each day). Varies by client. Meets Quality Review/Audit standards, as defined by the organization. Varies by client (e.g., 9.0/10 quarterly quality review score). Varies by client.