onsite licensed Nurse with prior authorization experience (lahug cebu)Omega Healthcare Management Services Inc.

Required Experience
 
· Candidates must possess a bachelor's degree.
o   Must be active license holder for PH-RN
·   Preferably with minimum of 1-year experience in Prior authorization
 
Job Duties and 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:
o   Perform outbound calls to payer's authorization department
o   Access payer's authorization online portal
o   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
·       Listen and review voicemail messages from payers then perform necessary actions required for the task