Prior Authorization and Eligibility Checker | Work From Home at Vector Outsourcing Solutions Phils. Inc.
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About this role
Salary: 30,000- 40,000 PHP/ month Job 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.
Performs other related duties as necessary or assigned
Eligibility and Benefits Verification:
Verify insurance eligibility for new and established patients by contacting insurance companies and using online verification systems.
Review insurance plans to ensure proper coverage for Senior/Elder Care (e.g., wellness visits, screenings, and vaccinations).
Confirm patient benefits, co-pays, deductibles, and any specific requirements or limitations for Senior Care.
Provide patients with detailed information regarding their coverage, including potential out-of-pocket costs.
Minimum 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
Others:
Equipment/ company computer is provided
Work from Home
Originally posted on Himalayas