Insurance Verification And Authorization IV Auth Specialist

Discover your 100% YOU with MicroSourcing!

Position: Insurance Verification and Authorization (IV/Auth) Specialist

Location: Taguig

Work setup & shift: Onsite | Night shift

Why join MicroSourcing?

Youll have:

• Competitive Rewards: Enjoy above-market compensation, healthcare coverage on day one, plus one or more dependents, paid time-off with cash conversion, group life insurance, and performance bonuses
• A Collaborative Spirit: Contribute to a positive and engaging work environment by participating in company-sponsored events and activities.
• Work-Life Harmony: Enjoy the balance between work and life that suits you with flexible work arrangements.
• Career Growth: Take advantage of opportunities for continuous learning and career advancement.
• Inclusive Teamwork: Be part of a team that celebrates diversity and fosters an inclusive culture.

Our client, Huron, is a global professional services firm that collaborates with clients to put possibilities into practice by creating sound strategies, optimizing operations, accelerating digital transformation, and empowering businesses and their people to own their future. By embracing diverse perspectives, encouraging new ideas, and challenging the status quo, Huron creates sustainable results for the organizations they serve.

Your Role

The Insurance Verification and Authorization (IV/Auth) Specialist verifies eligibility and initiates and/or follows up on prior authorization requests with insurance companies, providers, and patients in the US. They ensure timely and accurate processing of authorization requests, coordinate with clinical teams, and maintain compliance with payer guidelines and HIPAA standards. Excellent communication skills, attention to detail, and strong analytical and problem-solving abilities are essential for success in this role.

As an IV/Auth Specialist, you will:

IV/Auth Assignment

• Insurance Verification
• Verify insurance and benefit eligibility for patient services
• Authorization
• Review clinical documentation and insurance guidelines to determine authorization requirements
• May be responsible for verifying authorizations obtained by provider offices are accurate, including correct CPT code, patient demographics, and effective dates that cover the scheduled service date
• May be responsible for obtaining authorizations for scheduled services from insurance or third parties as necessary to financially secure services
• Ensure timely submission and follow-up of prior authorization requests to meet turnaround time (TAT) expectations
• Identify and escalate authorization denials or delays in authorization to the appropriate team (e.g., Patient Access, Billing, etc.)
• May be responsible for notification of admission as required by payers
• May need to review medical necessity criteria and payer-specific guidelines
• Payer and Patient outreach and communication
• Perform outbound calls and online inquiries to insurance companies, providers, and patients to verify eligibility and to initiate and follow up on prior authorization requests
• Handle inbound calls from U.S.-based patients and providers, demonstrating effective communication skills, empathy, and familiarity with healthcare or revenue cycle management processes
• Coordinate with physician offices and clinical teams to obtain missing documentation
• Documentation
• Accurately enter and update authorization, eligibility, benefit, and patient demographic details in the client system (e.g., Epic, Meditech, Cerner)
• Documents all payer communication and account activity according to defined standards
• Maintain a high level of confidentiality, professionalism, and compliance with HIPAA and other regulatory standards to protect patient information
• Adhere to the IV/Auth quality and productivity standards established by the organization

Other duties and responsibilities as assigned.

What You Need

Non-negotiables

• Insurance Verification/Authorization Experience: At least one year of US Healthcare industry experience completing insurance verification and authorization activities
• Education: Senior High School Diploma or equivalent
• Software Knowledge: Experience with an electronic medical record (EMR) system (e.g., Epic, Cerner, Meditech, etc.)
• Strong understanding of insurance verification processes and benefit determination
• Familiarity with payer portals and insurance websites for checking authorization and eligibility status
• Proficiency in MS Office Standard Tools (Word, Outlook, Excel, etc.)
• Excellent verbal and written English communication skills and customer service skills (CEFR level of at least B2 for both verbal and written)
• Willingness to work onnight shifts and adapt to US time zones

Soft Skills

• Demonstrated ability to prioritize amid competing priorities
• Strong ability to analyze raw data, draw conclusions, and develop actionable recommendations
• Proven ability to adapt quickly to new and changing technical environments
• Ability to pay close attention to details; strong follow-up and follow-through skills
• Regularly makes complex decisions within the scope of the position, and is comfortable working independently
• Independent judgment, discretion, and decision-making abilities
• Demonstrates teamwork and integrity in all work-related activities
• Ability to interact with internal and external customers in a professional manner
• Strong analytical and critical thinking skills

Preferred skills/expertise

• Authorization Experience: Two or more years of US Healthcare industry experience completing insurance verification and authorization activities
• Education: Philippine bachelor’s degree or equivalent preferred
• RCM Knowledge: Knowledge of CPT and ICD-10 coding

About MicroSourcing

With over 9,000 professionals across 13 delivery centers, MicroSourcing is the pioneer and largest offshore provider of managed services in the Philippines.

Our commitment to 100% YOU

MicroSourcing firmly believes that our companys strength lies in our peoples diversity and talent. We are proud to foster an inclusive culture that embraces individuals of all races, genders, ethnicities, abilities, and backgrounds. We provide space for everyone, embracing different perspectives, and making room for opportunities for each individual to thrive.

At MicroSourcing, equality is not merely a slogan - its our commitment and our way of life. Here, we dont just accept your unique authentic self—we celebrate it, valuing every individuals contribution to our collective success and growth. Join us in celebrating YOU and your 100%!

For more information, visit www.microsourcing.com

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