Full-time

Prior Authorization Specialist

Posted by Freelancing Philippines • Philippines, Philippines, Philippines

📍 Philippines, Philippines 🕒 March 03, 2026

About the Role

Responsibilities:

  • Submit requests for prior authorizations to insurance companies or third-party payers.
  • Follow up on pending authorizations and ensure timely processing to prevent delays in patient care.
  • Document authorization information in patient records and update as needed.
  • Verify patients' insurance eligibility, benefits, and coverage limitations.
  • Check for requirements related to deductibles, copayments, and out-of-pocket expenses.
  • Inform patients of their authorization status and any potential delays or issues.
  • Work with physicians, nurses, and other healthcare providers to ensure accurate information is submitted.
  • Investigate reasons for denied authorization requests and resubmit or appeal as appropriate.
  • Communicate with insurance representatives to resolve any authorization issues.
  • Maintain accurate records of all authorization requests, approvals, and denials.
  • Ensure co...

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