Prior Authorization and Eligibility Checker

🔥 3 minutes ago

🇵🇭 Philippines – Remote

💵 ₱30k - ₱40k / month

⏳ Contract/Temporary

🟡 Mid-level

🟠 Senior

👻 Ghost score 1%

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.

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Vector Outsourcing Solutions Philippines

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 2014

🏥 Healthcare

📦 Logistics

📣 Marketing

Healthcare • Logistics • Marketing

Vector Outsourcing Solutions Philippines is a leading business process outsourcing (BPO) provider dedicated to enhancing the operational efficiency of its clients. With over 20 years of experience and a workforce of more than 300 employees, the company excels in delivering tailored outsourcing solutions, particularly to the healthcare sector, including services like medical billing and revenue cycle management. Vector Outsourcing focuses on optimizing client operations through technology and analytics, ensuring quality customer service, and reducing operational costs to foster growth for the businesses they support.

📋 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 necessary documentation to expedite approvals and ensure appropriate follow-up • Review the accuracy and completeness of requested information and ensure 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 • 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, including wellness visits, screenings, and vaccinations • Confirm patient benefits, co-pays, deductibles, and specific requirements or limitations for Senior Care • Provide patients with detailed information regarding coverage, including potential out-of-pocket costs

🎯 Requirements

• 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

🏖️ Benefits

• Work from home • Equipment/company computer is provided