WE ARE LOOKING FOR INSURANCE VERIFICATION AND PRIOR AUTHORIZATION SPECIALIST

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TYPE OF WORK

Full Time

SALARY

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HOURS PER WEEK

39

DATE UPDATED

Apr 9, 2026

JOB OVERVIEW

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Skilled Intake Specialist - Healthcare
---------- /open-jobs/

WHAT WE OFFER
-Compensation & Benefits
-Competitive compensation
-Monthly Company Bonus Program
-Paid Vacation Leave
-Healthcare Insurance
-PhilHealth Insurance
-Internet Allowance
-Holiday Bonus
-Work Environment & Growth
-100% remote work — work from anywhere with a stable internet connection

KEY RESPONSIBILITIES
Handle end-to-end insurance verification for new DME patients (urology, ostomy, catheter) via portal and phone, validating insurance information and HCPC codes, documenting results, and routing to appropriate teams.
Manage the full prior authorization lifecycle — collecting clinical documentation, submitting requests to payers, tracking status, initiating re-authorizations ahead of reorder dates, and flagging denials or appeals to internal contacts.
Conduct reverifications for existing patients with coverage changes, maintain the daily reverification queue, provide overflow support during high-volume periods, and flag patterns that may indicate seasonal spikes.
Ensure accurate documentation across all verification and authorization interactions.

REQUIRED QUALIFICATIONS
Minimum 3 years of experience in US medical insurance verification, prior authorization, or RCM — REQUIRED
Prior Authorization (PA) and Insurance Verification (IV) experience — REQUIRED
Healthcare experience — REQUIRED
Working knowledge of US payer portals (Availity, NaviMed, UHC, BCBS, Cigna, etc.)
Familiarity with HCPC codes and DME billing requirements, including ostomy and catheter products
Experience handling Medicare and Medicare Advantage plans
Strong English communication skills — written and verbal (phone calls to US payers required)
Ability to manage multi-stage caseloads with concurrent active authorizations
Familiarity with insurance change workflows, COB (coordination of benefits), and plan terminations
Close attention to detail and the ability to maintain quality under volume pressure
Comfortable working US Eastern Time hours remotely from any location
Experience in DME, urology, ostomy, catheter, home health, or specialty medical billing

SKILL REQUIREMENT
Healthcare Prior Authorization Insurance Verification
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