Sr. Rep, Customer Serv Ops (US Healthcare Prior Authorization)
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Job Location:
Taguig - Philippines
Monthly Salary:
Not Disclosed
Posted on:
15 hours ago
Vacancies:
1 Vacancy
Job Summary
POSITION SUMMARY
The role is responsible for the initiation of the prior authorization process for medical procedures medications and other healthcare services. This entry-level role involves working closely with healthcare providers insurance companies and patients to ensure timely approval for treatments.
ESSENTIAL FUNCTIONS
- Reviews incoming authorization requests and verify patient eligibility and benefits.
- Initiates prior authorization requests via phone fax or online portals.
- Tracks and follows up on the status of submitted authorizations.
- Communicates approval or denial outcomes to healthcare providers and patients.
- Maintains accurate records and documentation of all authorization activities.
- Collaborates with the billing and clinical teams to ensure accuracy of information.
- Complies with HIPAA rules appropriately safeguarding PHI or other private & confidential information.
- Maintains accurate and detailed notes in the company system.
- Adapts quickly to frequent process changes and improvements.
- Is reliable engaged and provides feedback to improve processes and policies.
- Attends all department team and weekly company meetings as required.
- Appropriately routes incoming calls when necessary.
- Meets company quality standards.
- Embraces and exemplifies Cardinal Health Values:
Invites Curiosity Builds Partnerships Inspires Commitment Develops Self and Others
Qualifications
(1) At least 2 years of college coursework or experience
(2) Knowledge in Healthcare Operations specifically Prior Authorization is required
(3) Experience in using Contact Center phone system such as NICE and/or Genesys is an advantage
Candidates who are back-to-work people with disabilities without a college degree and Veterans are encouraged to apply.
Cardinal Health supports an inclusive workplace that values diversity of thought experience and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. Cardinal Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race religion color national origin ancestry age physical or mental disability sex sexual orientation gender identity/expression pregnancy veteran status marital status creed status with regard to public assistance genetic status or any other status protected by federal state or local law.
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Required Experience:
Senior IC
Key Skills
- Revenue Cycle Management
- HIPAA
- Healthcare Management
- PMBOK
- Microsoft Outlook
- Project Leadership
- Data Management
- Project Management
- Affiliate Marketing
- Project Management Software
- Supervising Experience
- Workday
About Company
Cardinal Health improves the cost-effectiveness of healthcare. We help focus on patient care while reducing costs, enhancing efficiency and improving quality.
