Healthcare Authorization Specialist

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Sourcefit

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🤝 B2B

☁️ SaaS

🎯 Recruiter

B2B • SaaS • Recruitment

Sourcefit is a leading business process outsourcing company with headquarters in the Philippines and offices in the Dominican Republic, Armenia, Madagascar, and South Africa. Founded in 2009, Sourcefit specializes in providing custom offshore and nearshore staffing solutions across various industries including IT, Finance, Healthcare, Retail, and more. They focus on offering efficient and cost-effective BPO services such as telesales, customer support, content moderation, IT support, web development, and more. Sourcefit is committed to building long-term value for organizations through customized, efficient, and integrated offshore staffing solutions.

📋 Description

• 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.

🎯 Requirements

• 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.

🏖️ Benefits

• Will follow US holidays