USRN Team Lead

On-site - Pasig 1-3 Yrs Exp Bachelor Full-time

Responsibilities

• Prioritize incoming authorization and referral requests according to queue urgency
• Review patient’s clinical and chart documentation related to the service submitted by the provider’s office
• Obtain and/or follow up on authorization and referral requests from the patient’s payer/s through any of the following methods—depending on the payer’s policy:
• Perform outbound calls to payer’s authorization department
• Access payer’s authorization online portal
• Submit faxes to payer’s authorization department
• Respond to payer’s clinical questions to be able to proceed with the authorization and referral requests
• Obtain and/or follow up payer’s peer-to-peer review requirements and send them back to provider’s office for the actual initiation
• Cater inbound calls from payers and perform necessary actions required for the task