Sr. Representative, Customer Service Operations (Prior Authorization)
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Job Location:
Taguig - Philippines
Monthly Salary:
Not Disclosed
Posted on:
16 hours ago
Vacancies:
1 Vacancy
Job Summary
POSITION SUMMARY
This role is responsible for processing prior authorization requests efficiently while adhering to payer guidelines and policies.
ESSENTIAL FUNCTIONS
Handles complex prior authorization requests including high-cost medications and procedures.
Serves as a point of contact for escalated authorization issues.
Assists in reviewing insurance policies to ensure compliance with payer requirements.
Coordinates with healthcare providers and insurance companies to resolve discrepancies.
Ensures timely submission and follow-up on authorization requests.
Reviews incoming authorization requests and verifies 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 ADS core values:
Invites Curiosity Builds Partnerships Inspires Commitment Develops Self and Others
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
- Typing
- Data Entry
- Customer Service
- Basic Math
- Computer Skills
- Windows
- Banking
- Upselling
- Pricing
- Sanitation
- Cash Handling
- Stocking
About Company
Cardinal Health improves the cost-effectiveness of healthcare. We help focus on patient care while reducing costs, enhancing efficiency and improving quality.
