Healthcare CSR - Authorization Specialist

About FGC+

#SparkSuccess at FGC+!

Since 2011, FGC+ has been committed to transforming US businesses through our all-inclusive outsourcing solutions. Through the years, weve built strong remote teams, developed customized processes, and provided exceptional customer service, helping companies soar to new heights. Our dedicated professionals excel in supporting a diverse range of industries with unmatched dedication.

Driven by our core values of Empathy, Reliability, Possibility, and Growth, we are focused on #IgnitingPossibility and helping each team member unlock their full potential. At FGC+, we offer more than just a job; we provide a nurturing environment where work-life balance, mentorship, employee engagement, and continuous learning are the pillars of your success.

Here, you are more than just an employee—you are part of a team where you can truly thrive and make a difference.

About The Job

An Authorization Specialist is an advocate on behalf of patients and facilities to obtain approval with authorizations and referrals for different healthcare services. Review and convey clinical documentation to insurance to obtain medical necessity authorizations to assist in obtaining maximum services for the patient and provider.

What Youll Do

• Ensures to work timely on the daily authorization requests of the providers and facilities
• Initiates auth requests through different insurance portals and by calling insurances
• Obtains and follow up status of authorization
• Advocates with various insurance companies for authorizations in various levels of care
• Coordinating with providers on documentation, medical need and authorizations
• Responds to inquiries from insurance companies and document accordingly and communicate with providers
• Must be able to read and identify medical records
• Updates the accounts as required by client guidelines and processes accordingly
• Ensures forms and logs are filled out as required by client guidelines and processes accurately and complete
  
  

• At least 1 year of experience in BPO handling Healthcare account
• Experience in Pre-authorization, Utilization Review and Case Management is an advantage
• Excellent verbal and written communication skills
• With exemplary probing and problem-solving skills
• Strong attention to detail and ability to adapt to constantly changing environment
  
  

• A company culture based on our purpose to bring out the untapped potential, creativity, and success in people, partnerships, and brands.
• A culture built on the mission to develop high-functioning teams by providing an environment of constructive support and inspiration where people grow personally and professionally
• A market competitive total compensation/rewards package including:

• Day 1 HMO
• Competitive pay including incentives and generous allowances
• Payment of all statutory government benefits
• 25 days of annual paid leave some days are convertible to cash
• 13th month pay
• Onsite medical support
• Employee Engagement Events
• Employee Referral Program
• Skills, training for personal and professional development