Prior Authorization Specialist

Quezon City, Metro Manila
Permanent
Full-time

9 days ago

Job Summary:Reporting to the Clinical Director and working closely with the Clinical Team, this role plays a key part in ensuring the financial health of the organization. The position serves as a vital link between patients with mental health and/or substance use disorders and insurance providers, healthcare services, and billing operations. It is essential to the success of the companys programs.Key Responsibilities:Therapy/IOP Prior Authorizations (PARs):

Confirm insurance coverage
Monitor and track therapy sessions weekly
Coordinate with therapists to obtain necessary documentation
Prepare and submit PARs
Upload and organize submissions; maintain tracking sheets
Notify RMH Manager and therapists of authorization outcomes

Residential Mental Health (RMH) PARs:

Verify insurance eligibility
Complete and submit RMH PARs
Upload and organize documentation
Communicate approval or denial status to RMH Manager and therapists

Housing PARs (if applicable):

Monitor the housing PAR request tracker
Collaborate with therapists to write clinical snapshots
Ensure accuracy of the tracker
Inform the housing team of approved applicants

Qualifications:

Bachelor's degree required
With at least 1 year experience in Prior Authorization.

General Duties:

Respond promptly to emails and phone calls
Provide timely updates to third-party payers
Complete daily documentation
Submit Superbills within 24 hours of patient discharge
Attend all required meetings
Support the Clinical Director, RMH Manager, and Therapy Team as needed

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