Full-time
Prior Authorization Specialist
Posted by Freelancing Philippines • Philippines, Philippines, Philippines
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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