Prior Authorization and Eligibility Checker | Work From Home

Salary: 30,000- 40,000 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 Originally posted on Himalayas