Healthcare Authorization & Eligibility Specialist

🌟 We're Hiring: Healthcare Authorization & Eligibility Specialist! 🌟

The Benefits Specialist (Healthcare Authorization & Eligibility Specialist) plays a key role in ensuring seamless operations regarding the authorizations and eligibility of our customers’ clients. This person is responsible for handling eligibility verification, authorization renewals, missing client or claims issues, conducting authorization research, and participating in the customer onboarding process. This position will report to the Benefits Operations Manager.

📍 Location: Pasig, Philippines
⏰ Work Mode: Work From Office
💼 Role: Healthcare Authorization & Eligibility Specialist

What You'll Do:
• Ensure 90% of requested authorizations are successfully renewed
• Identify and address missing clients and/or claims from reports within Paradigm’s billing management tool
• Enter authorization information into Paradigm's system and the customer’s scheduling software to ensure an accurate and seamless billing process
• Demonstrate strong communication skills when responding to customer emails using the ticketing system
• Communicate with customers via email, phone, and video calls to ensure their satisfaction
• Research the authorization renewal process at VA Medical Centers to better understand their processes and improve Paradigm’s authorization renewal processes for handling VA authorizations
• Determine eligibility for our customers’ Medicaid clients to ensure their eligibility to receive service
• Conduct virtual weekly meetings with customers to facilitate the authorization management service onboarding process
• Work cross-functionally to ensure the execution of all responsibilities and support team members

What We're Looking For:
• Minimum 1 year of experience working in health care
• Minimum 1 year of customer service experience
• Strong problem-solving skills
• Excellent organizational skills and attention to detail
• Excellent follow-up, time management, and communications skills
• Proficiency in MS Office Suite (Outlook, Word, Excel) required

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