Prior Authorization and Eligibility Checker
Posted 5 days ago
You'll complete your application on Vector Outsourcing Solutions Philippines's career site.
About the Role
We are looking for a committed Prior Authorization and Eligibility Checker to assist with healthcare operations. This position is vital for successful revenue cycle management through the verification and approval of medical services by insurance carriers. This role is perfect for an experienced healthcare BPO professional who wants to utilize their skills in a remote, supportive setting. You will collaborate with a team dedicated to enhancing administrative efficiency and delivering high-quality service to clinicians and patients. You will contribute to lower operational expenses and a better patient experience in this temporary contract role. Working from home, you will handle intricate insurance procedures and medical documentation to ensure that all filings and communications are thorough and prompt to avoid hindering patient care.
Requirements
- You should possess a bachelor’s degree, ideally in a medical-related discipline, although this is optional.
- You are required to have a minimum of one year of hands-on experience with prior authorization workflows in a healthcare BPO setting.
- You must demonstrate excellent verbal and written English skills to interact professionally with patients, doctors, and insurance carriers.
- You must show a proven capacity to handle various tasks at once with strong organizational skills and a focus on the customer.
- You must be prepared to operate from a home office with a stable internet connection and be available for shifting schedules, which will mainly consist of night shifts.
- You must commit to the full six-month duration of the contract.
Responsibilities
- You will oversee incoming prior authorization requests through fax, phone, or the Electronic Health Record system.
- You will validate insurance eligibility for both returning and new patients by using online portals and communicating with insurance providers.
- You will evaluate medical records and insurance policies to guarantee that services like wellness visits and screenings are covered, while verifying benefit details, deductibles, and co-pays.
- You will handle communications with patients, specialists, and physicians, maintaining precise documentation of all exchanges in the system.
- You will compile and send medical data to insurance companies to secure rapid approvals, track pending requests to ensure all required documentation is present, and explain coverage restrictions or potential personal expenses to patients.
Benefits & Perks
- You will benefit from a fully remote work-from-home position.
- The organization will supply all required equipment, including a company-issued computer, to support your work.
Note: This listing is summarized and paraphrased by WorkNow from a publicly posted role. For the original wording and full details, please refer to the employer's official posting.
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