About this 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 skillsWilling to work onsite in Makati Amenable working night shiftBenefits
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