Job Category: Healthcare/ Customer Support
Job Type: Full Time
Job Location: Urdaneta City Pangasinan or Makati City
Basic Pay: Negotiable
Shift: Night U.S Time Zone

📢 We’re Hiring: Prior Authorization Specialist

ALTRUST Services is looking for detail-oriented and highly organized Prior Authorization Specialists to support healthcare operations for U.S.-based medical providers and healthcare organizations.

This role is responsible for managing prior authorization requests, insurance verification, payer follow-ups, and documentation coordination to help ensure timely approvals and uninterrupted patient care.

You will work closely with healthcare providers, insurance payers, and internal support teams in a structured, office-based healthcare operations environment.

If you are proactive, process-driven, and experienced in U.S. healthcare workflows, we’d love to hear from you.

🎯 Key Responsibilities

Prior Authorization Processing

  • Submit and manage prior authorization requests for medications, procedures, imaging, and treatments
  • Complete payer forms and portal submissions accurately and efficiently
  • Ensure all required clinical documentation is attached and properly submitted
  • Track authorization statuses and follow up on pending requests

Insurance Verification & Eligibility

  • Verify patient insurance coverage, benefits, and eligibility
  • Review payer requirements for authorization approval
  • Identify missing information or documentation that may delay approvals

Payer Follow-Up & Communication

  • Contact insurance companies regarding authorization status, denials, and additional requirements
  • Escalate urgent or delayed cases when necessary
  • Document all payer interactions accurately in internal systems

Provider & Patient Coordination

  • Coordinate with healthcare providers and clinical staff to obtain supporting documentation
  • Communicate authorization updates and outstanding requirements when needed
  • Ensure timely processing to avoid treatment delays

Documentation & Record Management

  • Maintain accurate and organized authorization records
  • Update tracking systems and internal databases consistently
  • Ensure compliance with company documentation standards and confidentiality requirements

Workflow & Operational Support

  • Assist in improving prior authorization workflows and turnaround times
  • Support operational reporting and productivity tracking
  • Collaborate with supervisors and QA teams to maintain service quality

✅ Must-Have Qualifications

  • At least 1–2 years experience in prior authorization, insurance verification, medical billing, or U.S. healthcare support
  • Strong understanding of U.S. healthcare insurance processes and payer workflows
  • Excellent English communication skills (written and verbal)
  • Strong attention to detail and organizational skills
  • Ability to manage multiple cases and deadlines simultaneously
  • Experience using EMR/EHR systems, payer portals, or healthcare platforms
  • Comfortable working night shift (U.S. time zone)
  • Professional communication and problem-solving skills

🌟 Preferred Qualifications

  • Experience handling U.S. prior authorization workflows
  • Background in healthcare BPO or healthcare operations
  • Familiarity with:
    • Availity
    • CoverMyMeds
    • Athenahealth
    • Kareo
    • Epic
    • eClinicalWorks
  • Allied health or healthcare-related educational background
  • Experience working in office-based healthcare support operations
  • Familiarity with HIPAA-conscious workflows and documentation handling

🏢 Work Environment

This is an office-based role under ALTRUST Services’ supervised healthcare operations setup.

Work locations:

  • Makati City
  • Urdaneta City, Pangasinan

Our teams operate in structured, secure environments designed to support productivity, accountability, collaboration, and operational continuity.

🚀 Why Join ALTRUST Services?

  • Structured healthcare operations environment
  • Professional and supportive leadership
  • Opportunities for long-term growth
  • Stable office-based setup
  • Collaborative healthcare support culture
  • Exposure to U.S. healthcare operations workflows
prior authorization specialist

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