Full Description

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?

You'll 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.