Medical Prior Authorizations Specialist
Full Time ₱23,000 - ₱28,000 / monthJob Overview
Virtual Staffing Solutions is currently looking for a detail-oriented and proactive Medical Prior Authorization Specialist to support our clinical teams by ensuring patients receive timely access to the care they need. In this role, you will be a critical link between providers, insurance payors, and patients—helping prevent delays, reduce claim denials, and streamline the authorization process.
Key Responsibilities
- Verify patient insurance eligibility and benefits before scheduled appointments or procedures.
- Obtain prior authorizations for medications, imaging, and procedures via payor portals, fax, or phone.
- Track and follow up on pending authorizations to ensure timely approval.
- Process denial appeals by compiling supporting clinical documentation and submitting reconsideration requests.
Skills, Knowledge & Expertise
- Must have at least 6 months of experience in insurance verification, eligibility, or prior authorization.
- Preferably with experience in denial management or appeals, as well as supporting multi-specialty clinics or telehealth practices.
- Working knowledge of commercial and government payors (Medicare, Medicaid).
- Familiarity with electronic health record (EHR) systems and insurance portals.
- Strong written and verbal communication skills.