Philippines Job Openings
Gratitude Inc.
Clinical Authorization Specialist (PHRN)
Taguig
FULL TIME
September 15, 2024
We have an ongoing hiring for a Clinical Authorization Specialist for our Healthcare BPO Partner in Taguig. We are also in need of Team Leader and QAs for the Clinical Authorization.
Position: Clinical Authorization Specialist
Location: BGC, Taguig and onsite
Salary: Upto Php47,500 depending upon overall experience
Job Type: Permanent
Shifts: Rotational
No. of opening: 5
COMPETENCIES, SKILLS AND OTHER REQUISITES:
- Excellent written and spoken English
- Unflinching integrity and personal work ethics
- Self-starter who strives forself and team excellence
- Flair for client satisfaction
- Attention to detail and concern for accuracy
- Excellent time management skills and multi-tasking ability
- Excellent team player
- Compliant to rules and regulations
- With relevant experience in Clinical Authorization
- Academic qualification for this role is a graduate in Nursing.
- Required Certifications/Licensure Registered Nurse currently licensed
- With Hospital Setting experience
- Awareness and implementation of ISO, ISMS and GRIC policies
- Adherence to the rules and regulations as outlined by the management.
- Contact insurance carriers to verify patient’s insurance eligibility, benefits and requirements.
- Request, track and obtain pre-authorization from insurance carriers within time allotted for medical and services.
- Review, request, follow up and secure authorizations for high dollar cost oncology chemotherapy drugs.
- Demonstrate and apply knowledge of medical terminology, high proficiency of general medical office procedures including HIPAA regulations.
- Assist with medical necessity documentation to expedite approvals and ensure that appropriate follow-up is performed.
- Review denials and follow up with provider to obtain medically necessary information to submit an appeal of the denial.
- Prioritize the incoming authorizations by level of urgency to the patient.
- Manage correspondence with insurance companies, physicians, specialists, and patients as needed, including documenting in the EHR as appropriate.
- Respond to clinical questions regarding payer medical policy guidelines.
- Competitive remuneration + annual performance-based bonus +standard industry benefits. Relocation package, per company policy will apply to candidates outside the office base city.
1. Personal Interview (HR)
2. Domain Panel Interview
3. HR Discussion
To apply, please submit your updated resume on this post or via email at isay@gratitudephilippines.com and answer the pre-screening questions.
Further details will be discussed once invited for an interview.
Our recruitment team will reach out to you via Whats App or direct call once shortlisted.
APPLY NOW!
Job Type: Full-time
Pay: Php35,000.00 - Php47,500.00 per month
Application Question(s):
- How many years of Clinical Authorization experience do you have? (REQUIRED)
- How many years of Clinical experience in hospital set-up do you have? (REQUIRED)
- Are you a Registered nurse with an active license?
- Are you amenable to working onsite at BGC Taguig and with rotational work schedule for our healthcare BPO Partner? (REQUIRED)
- How much is your last drawn salary? (REQUIRED)
- How much is your salary expectation? (REQUIRED)
- When are you available to start? (REQUIRED)
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