Prior Authorization Specialist (with Medical Billing experience) - Permanent WFH
BizForce, Philippines
Job Description
#1 PH Workforce Delivering to the US
MedCore Solutions, is seeking a skilled Prior Authorization Specialist with Medical Billing experience to join our growing team. We are partnering with some of the largest healthcare platforms in the world. If you are looking to advance your career and improve your skills with an industry leader, we encourage you to apply today! The traditional model of the office workforce has been shifting as outsourcing has grown in PH at rates never before seen. As global businesses rise out of the pandemic, labor markets have not only tightened but the inflationary rates have caused companies to look for solutions on how to best deliver skilled labor services and results. We are proud to partner with PH and deliver qualified, professional workers, giving our employees the ability to have an unbeatable career and work from home.
Who We Are
MedCore Solutions (MCS) is a single source solution for Healthcare administration. MCS is an industry leader for medical billing, credentialing, scribing, insurance verification, compliance and virtual staffing.
Responsibilities
- Review and process prior authorization requests for medical services, procedures, and medications
- Verify insurance information and eligibility
- Coordinate with healthcare providers and insurance companies to obtain necessary authorizations
- Ensure accurate and timely documentation of authorization requests and approvals
- Collaborate with medical billing team to resolve any issues or denials
- Maintain up-to-date knowledge of insurance guidelines and procedures
- Manage accounts receivables and keep up-to-date records
- Tasks will gradually transition into a Biller/AR task
- Coordinate with healthcare providers and insurance companies for claim submission and follow-up
- Generate revenue by making payment arrangements, collecting accounts, and monitoring and pursuing delinquent accounts
- Verify insurance eligibility for patients and ensure timely payment
- Handle denied claims and appeal if necessary
- Reconcile payments and post to patients' accounts
- Maintain compliance with HIPAA regulations
- Handle patient inquiries regarding their accounts
Requirements
Requirements:
- Previous experience as a Prior Authorization Specialist in a medical billing setting
- Strong understanding of medical billing and insurance processes
- Excellent communication and interpersonal skills
- Detail-oriented with strong organizational skills
- Ability to work independently and meet deadlines
- Proficient in using medical billing software and MS Office Suite
- High school diploma or equivalent, relevant certifications a plus
- Comfortable working in a remote, work-from-home setup
Benefits
Our Commitment to delivering high-quality results for our clients and the only way to do that is ensuring a rewarding, respectful and productive experience for our employees. We hold the same values for both our customers and our employees.
- Permanent Work From home
- Permanent Weekends Off
- Great Company Culture and No Micromanagement
- Continued Education
- Specialized Training