[Hiring] Healthcare Authorization Specialist @Sourcefit

Role Description

We are seeking a detail-oriented Healthcare Authorization Specialist to support the timely coordination of insurance verification and prior authorization processes for patient treatments. This role is responsible for:

• Verifying insurance eligibility and coverage
• Obtaining prior authorizations
• Maintaining accurate documentation
• Coordinating with insurance providers and internal teams to ensure patients receive timely access to care

The ideal candidate has strong analytical and organizational skills, excellent communication abilities, and a solid understanding of medical terminology. The ability to work efficiently and accurately under time-sensitive conditions is essential as this role directly supports patients awaiting cancer treatment.

Qualifications

• Experience in healthcare prior authorization, insurance verification, medical billing, revenue cycle, or a related healthcare administrative role is preferred
• Strong understanding of insurance eligibility verification, prior authorization processes, and healthcare payer requirements
• Familiarity with medical terminology
• Experience navigating insurance payer websites and online portals
• Excellent verbal and written communication skills, with the ability to interact professionally with insurance representatives and internal teams
• Strong attention to detail and a high level of accuracy when handling patient and insurance information
• Strong analytical and problem-solving skills
• Excellent organizational and time management skills, with the ability to prioritize tasks in a fast-paced environment
• Ability to work independently while managing multiple authorization requests and meeting strict turnaround times
• Proficiency in Microsoft Office applications and healthcare information systems or electronic medical records (EMR/EHR) is an advantage
• Ability to perform effectively in a time-sensitive environment where timely authorizations directly impact patient access to cancer treatment

Requirements

• Work from Home
• Schedule: Monday to Friday | 9:00 PM to 6:00 AM (Manila Time)
• Holiday: Will follow US holidays

Responsibilities

• Verify patient insurance eligibility, benefits, and coverage prior to treatment or service
• Secure prior authorizations from insurance companies for scheduled medical services and treatments
• Complete and submit authorization requests accurately and within required turnaround times
• Communicate with insurance providers via phone and payer portals to obtain authorization approvals and verify coverage details
• Coordinate with internal clinical and administrative teams regarding authorization status and any additional documentation requirements
• Maintain accurate and up-to-date records of insurance verifications, authorizations, approvals, denials, and follow-up activities
• Monitor pending authorization requests and proactively follow up to prevent delays in patient care
• Review payer requirements and ensure all submitted documentation meets insurance guidelines
• Escalate authorization issues or delays to the appropriate internal stakeholders when necessary
• Ensure compliance with patient confidentiality requirements and applicable healthcare regulations
• Perform other related duties as assigned