RRP Prior Authorization Specialist

Job not on LinkedIn

🕒 July 29

🇵🇭 Philippines – Remote

💵 $5 / hour

⏳ Contract/Temporary

🟢 Junior

🟡 Mid-level

✨ Prior Authorization Specialist

🚫👨‍🎓 No degree required

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

EMS

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1964

🏥 Healthcare

🏭 Manufacturing

💊 Pharmaceuticals

Healthcare • Manufacturing • Pharmaceuticals

EMS is the largest pharmaceutical laboratory in Brazil, recognized for its commitment to providing effective and affordable health solutions. With over 55 years in the industry, EMS operates in more than 40 countries and offers a diverse portfolio of products, including innovative treatments for chronic conditions such as obesity and diabetes. The company also emphasizes social responsibility and quality, investing in research and development to ensure high standards in the medications it produces.

📋 Description

• Coordinate the prior authorization and intake process for clients entering or receiving services through the Residential Recovery Program (RRP) • Ensure all required authorizations are obtained before admission or continuation of residential treatment services • Prepare, submit, and track initial and concurrent prior authorization requests for residential treatment services • Monitor authorization expiration dates and proactively submit reauthorization requests before coverage expires • Communicate with Medicaid Managed Care Organizations (MCOs), commercial insurance carriers, and other payers regarding authorization status • Maintain organized electronic documentation to support regulatory compliance, payer audits, and internal quality reviews

🎯 Requirements

• High school diploma or equivalent required • Associate's or Bachelor's degree in Healthcare Administration, Business Administration, Health Information Management, or a related field preferred • Ability to successfully complete required background and reference checks • Minimum of 1–2 years of experience in healthcare prior authorizations, utilization management, admissions, intake coordination, or insurance verification • Experience supporting Residential Recovery Programs (RRP), Substance Use Disorder (SUD) treatment, behavioral health, or residential treatment programs strongly preferred • Working knowledge of Maryland Medicaid and Managed Care Organization (MCO) authorization requirements preferred • Experience using Electronic Health Records (EHR), payer portals, and Microsoft Office applications preferred

🏖️ Benefits

• Not eligible (Independent Contractor position)