PHRN – Clinical Authorization, Taguig

Description

Job title: PHRN Clinical Authorization
Work set up: Onsite Opportunity MCK Taguig, Cyber Sigma Building
Work schedule:Weekdays Night Shift schedule, Fixed Weekends Off
Salary: 45K to 50K package if licensed PHRN, salary for approval if non-licensed

Contact insurance carriers to verify patients 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

Highlights

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