[Hiring] Prior Authorization and Eligibility Checker @Vector Outsourcing Solutions Phils. Inc.

Role 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.
• Perform other related duties as necessary or assigned.

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.

Requirements

• Equipment/company computer is provided.
• Work from Home.