We are seeking a detail-oriented and compassionate Customer Service Representative (CSR) to join our Healthcare team, specifically supporting prior authorization services. In this role, you will assist patients, providers, and pharmacy professionals by verifying benefits, explaining coverage, and facilitating prior authorization requests for healthcare services and medications.
Qualifications :
- Must be College graduate in any Medical Allied course
- 6 months experience in healthcare
- Preferably with prior authorization experience.
- Good to excellent comms skills.
- Can start ASAP.
Responsibilities :
Handle end-to-end prior authorization requests for healthcare services or medicationsVerify patient insurance eligibility and coverage detailsReview and collect required clinical documentation for submissionSubmit PA requests to insurance payers via portal, fax, or phoneTrack and follow up on submitted authorizations to ensure timely processingCommunicate authorization status, approvals, or denials to providers and patientsAssist with appeals and additional documentation requests when neededMaintain accurate records in system and ensure HIPAA compliance