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    Customer Service Representative - Philippines, Quezon City, Pilipinas - MicroSourcing

    MicroSourcing
    MicroSourcing Philippines, Quezon City, Pilipinas

    5 araw ang nakalipas

    Default job background
    Buong oras Teknolohiya/Internet
    Paglalarawan
    Job Description
    • Check the Prior Authorization Request (PAR) status in the portal, if available, before initiating contact with the Insurance Prior Authorization (PAR) department.
    • Open sales orders and thoroughly examine the case details.
    • Check workflow notes to understand the specific follow-up requirements.
    • Utilize the PAR Follow-up Note Template in the Workflow notes when calling the insurance to follow up on prior authorizations.
    • Liaise with insurance representatives to obtain determination status.
    • Engage with insurance representatives to obtain and confirm PAR status, ensuring accuracy and completeness of information.
    • Confirm relevant codes and inquire about turnaround times (TAT).
    • Retrieve pending authorization numbers or ascertain if additional paperwork is required.
    • Request fax backs for determination letters.
    • Conduct continuous follow-ups with insurance until the paperwork is received.
    • Create floating tasks to notify Prior Authorization Specialists of determinations or feedback.
    • Coordinate with Prior Authorization Specialists if unable to reach insurance after 1 or 2 attempts.
    • Seek alternate contact numbers, as the listed numbers may not always be accurate.
    • Be prepared to answer questions about the call, document details, and faxing specifics.
    • Follow PAR Submitted, PAR Follow-up, and PAR Received note templates for accurate documentation in the workflow notes.
    • Document the PAR status in the workflow by adhering to the PAR Submitted, PAR Follow-up, and PAR Received note templates in Workflow notes.
    • Navigate and use workflow tools effectively to streamline and document the prior authorization process.
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