About the role
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
- Healthcare Account experience is a PLUS
- Excellent 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