Authorization Specialist

Join our team as an Authorization Specialist! In this vital role, you’ll ensure timely and accurate insurance authorizations that support smooth patient access to therapy services. You’ll work closely with clinical and billing teams to verify benefits, manage payer communications, and maintain compliance with all regulatory requirements. If you have strong attention to detail, excellent communication skills, and experience in healthcare authorizations, we’d love to have you on board!

Job Description

The Authorization Specialist plays a key role in ensuring timely and accurate insurance authorizations for therapy services. This position supports smooth patient access and efficient reimbursement by obtaining and verifying pre-certifications, managing payer communications, and maintaining compliance with all regulatory and payer requirements.

Responsibilities

Review incoming therapy referrals, prescriptions, and patient information to determine authorization requirements.
Obtain pre-authorizations and re-authorizations for physical therapy, occupational therapy, and other clinical services as required by insurance payers.
Verify insurance eligibility and benefits prior to treatment and communicate coverage details to the clinical and front office teams.
Document all authorization approvals, denials, and related correspondence in the practice management and EHR systems accurately.
Track and monitor authorization expirations, ensuring continuity of care and timely renewals.
Communicate with insurance representatives, clinical staff, and patients regarding authorization status and payer updates.
Collaborate with billing and collections teams to resolve authorization-related claim issues and denials.
Maintain knowledge of payer policies, CPT codes, and medical necessity requirements relevant to rehabilitation services.
Support compliance with HIPAA and company confidentiality policies at all times.

Minimum Qualifications

Applicants must be willing to work in San Jose del Monte, Bulacan.
Graduate of any bachelor’s degree course.
Prior experience in rehabilitation, physical therapy, or outpatient medical services strongly preferred.:
Knowledge of insurance carrier requirements, CPT/ICD-10 coding, and therapy authorization processes.
Strong attention to detail and organizational skills.
Excellent verbal and written communication abilities.
Proficiency with EHR systems, insurance portals, and Microsoft Office.
Ability to manage multiple priorities in a fast-paced environment.

Date Posted:

5 months ago

Location:

SJDM, Bulacan

Title:

Authorization Specialist

Job Type:

Full-time

Category:

Non-Clinical

Account:

Voice and non-voice accounts

Shift:

Night Shift

Experience Level:

1–2 years of experience in authorization, insurance verification, or billing in a healthcare setting.