Authorization Specialist (US Healthcare)

ISTA Solutions, an outsourcing/offshoring company, is in search of an experienced Healthcare Customer Service Representative to join our rapidly expanding team. As a member of our team, you will have the opportunity to work with highly skilled professionals, who prioritize employee satisfaction and work-life balance. At ISTA Solutions, we pride ourselves on creating a culture focused on long-term success and life-long learning. We're looking for a team player who is ready to contribute to our mission, just like you!

Account specific roles and responsibilities

Authorization Management:

• Obtain necessary pre-authorization approvals for medical services as required by insurance companies.
• Verify eligibility and benefits through insurance portals or direct contact with insurance carriers.
• Ensure timely submission of authorization requests and follow up on pending approvals.
• Maintain accurate records of all authorization communications, approvals, and denials.

Eligibilities:

• Perform eligibility and benefits verification for treatments, hospitalizations, and procedures.

• Reviewing patient bills for accuracy and completeness and obtaining any missing information.

Compliance and Documentation:

• Maintain up-to-date knowledge of insurance requirements, authorization processes, and credentialing guidelines.
• Stay informed about changes in insurance policies, regulations, and industry standards.
• Ensure that all documentation related to authorizations, credentialing, and billing is accurate, complete, and compliant.

Requirements

• 6 months - 1 year BPO experience handling US Healthcare Insurance

• Good working knowledge in checking and processing Authorization
• Knowledge with Healthcare Claims and Billing
• Good verbal and written English skills
• Must be willing to work on-site in Shaw, Mandaluyong
• Amenable working night shifts

Benefits

What can we offer you?

• Competitive salary and benefits
• Health Insurance with free dependents*
• 10%-night differential
• Attendance Bonus
• Paid time off
• Convertible to cash leave credits
• Performance Appraisal
• Work-life balance
• A focus on growing your career path with us
• We encourage you to follow your passions and learn new skills

Our commitment to you

• Strong culture and values-driven leadership
• We create opportunities for you to learn and grow at any stage of your career
• Continuous learning and innovation
• We foster an all inclusive environment where everyone thrives