ISTA Solutions, an outsourcing/offshoring company, is in search of an experienced Healthcare CSR to join our rapidly expanding team. As a member of our team, you will have the opportunity to work with highly skilled professionals, who prioritize employee satisfaction and work-life balance. At ISTA Solutions, we pride ourselves on creating a culture focused on long-term success and life-long learning. We're looking for a team player who is ready to contribute to our mission, just like you!

Account specific roles and responsibilities:

• Handle the complete prior authorization workflow from initiation to final determination.
• Review patient records and provider documentation to verify authorization requirements.
• Submit prior authorization requests to insurance carriers for services and procedures across Dental, Audiology, Cardiology, Pulmonology, Gastroenterology, and Women's Health specialties.
• Communicate with healthcare providers, insurance companies, and patients regarding authorization status and requirements.
• Monitor authorization requests, conduct follow-ups, and resolve pending or denied cases.
• Maintain accurate and up-to-date documentation in electronic health record (EHR) and practice management systems.
• Ensure compliance with payer policies, regulatory requirements, and organizational procedures.
• Escalate complex cases and collaborate with clinical teams to obtain additional supporting documentation when necessary.
• Track authorization outcomes and assist in identifying process improvement opportunities.

Requirements

• At least 6 months BPO experience handling a Healthcare Account
• Prior Authorization experience is an advantage
• Good verbal and written English skills
• Willing to work onsite in Makati
• Amenable working night shift

Benefits

What can we offer you?

• Competitive salary and benefits
• Health Insurance with free dependents*
• 10%-night differential
• Attendance Bonus
• Paid time off
• Convertible to cash leave credits
• Performance Appraisal
• Work-life balance
• A focus on growing your career path with us
• We encourage you to follow your passions and learn new skills

Our commitment to you

• Strong culture and values-driven leadership
• We create opportunities for you to learn and grow at any stage of your career
• Continuous learning and innovation
• We foster an all inclusive environment where everyone thrives