Healthcare Skilled Intake Specialist

Job OpeningsHealthcare Skilled Intake Specialist

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JOB OVERVIEW

We are looking for highly motivated and hard-working candidates to fill the Full-Time position of Intake Specialist for our Healthcare Account.

Open Roles

Insurance Verification Specialist

Prior Authorization Specialist

Reverification Specialist

• New patient benefits verification via portal & phone
• End-to-end prior auth lifecycle & document management
• Existing patient insurance changes & blended IV/PA support

KEY RESPONSIBILITIES

Responsibilities span across all three roles and include the following core functions

Insurance Verification

• Perform full insurance benefits verification for new DME patients (urology, ostomy, catheter) via portal and phone
• Verify the accuracy of insurance information and HCPC codes entered into patient accounts
• Contact insurance carriers by phone when portal verification is unavailable or incomplete
• Document all verification results in the system and route to the appropriate teams for processing
• Identify and flag insurance discrepancies, eligibility issues, or prior authorization requirements

Prior Authorization

Manage end-to-end prior authorization lifecycle for urology, ostomy, and catheter DME orders
Collect required clinical documentation from referral sources, physicians, and internal teams
Submit authorization requests to payers via portal, phone, or fax per payer requirements
Track authorization status and proactively follow up to ensure timely turnaround
Initiate re-authorization for existing patients ahead of reorder dates and communicate outcomes to CSR and clinical teams
Flag denials, peer-to-peer requests, and appeals to appropriate internal contacts
Support Workers' Compensation authorization workflows as the scope expands
Reverification & Overflow Support
Perform insurance reverifications for existing patients flagged due to coverage changes
Identify coverage discrepancies and update patient accounts with corrected insurance information
Monitor and work the daily reverification queue, routing accounts to appropriate teams
Provide overflow support for new patient insurance verification during high-volume periods
Flag patterns in insurance change activity that may indicate seasonal volume spikes
Maintain accurate documentation and notes for every verification and reverification interaction

REQUIRED QUALIFICATIONS

Minimum 3 years of experience in US medical insurance verification, prior authorization, or RCM — REQUIRED
Prior Authorization (PA) and Insurance Verification (IV) experience — REQUIRED
Healthcare experience — REQUIRED
Working knowledge of US payer portals (Availity, NaviMed, UHC, BCBS, Cigna, etc.)
Familiarity with HCPC codes and DME billing requirements, including ostomy and catheter products
Experience handling Medicare and Medicare Advantage plans
Strong English communication skills — written and verbal (phone calls to US payers required)
Ability to manage multi-stage caseloads with concurrent active authorizations
Familiarity with insurance change workflows, COB (coordination of benefits), and plan terminations
Close attention to detail and the ability to maintain quality under volume pressure
Comfortable working US Eastern Time hours remotely from any location

PREFERRED QUALIFICATIONS

• Experience in DME, urology, ostomy, catheter, home health, or specialty medical billing
• Familiarity with Medicare Advantage and MCO authorization requirements
• Workers' Compensation authorization experience
• Experience with clinical documentation portals and EMR/CRM systems used in US DME operations
• Prior authorization support experience, including document collection and status tracking
• Familiarity with open enrollment periods and the US insurance change seasonality
• Experience working with US healthcare clients via BPO or offshore staffing
• Home Office Requirements: (must provide screenshot)
• Stable internet connection with at least 100 Mbps postpaid
• Computer (at least 16GB RAM and Intel i5 core processor equivalent or up)

Noise-Cancelling Headset

Backup Internet Connection (Prepaid Home WIFI Router or Pocket WIFI) and Power Outage Backup

Dual Monitor

Benefits

Competitive compensation

Monthly Company Bonus Program

Paid Vacation Leave

Healthcare Insurance

PhilHealth Insurance

Internet Allowance

Holiday Bonus

• Work Environment & Growth
• 100% remote work — work from anywhere with a stable internet connection

Required for consideration

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