Prior Authorization Specialist

Job Description:

Location: Remote, Philippines

Job Type: Full-Time

Work Location: Remote

Schedule: Monday to Friday, 9:00 AM to 6:00 PM U.S. Central Time

Salary: $360 to $470 per month, based on qualifications and experience

About PsychPlus

PsychPlus is reimagining how mental health care is delivered in the United States through a modern, digital-first model. We provide care both in person at our offices across Texas and virtually, combining clinical care with technology to improve access to high-quality mental healthcare.

As PsychPlus continues to grow, our Revenue Cycle Management team is expanding to support U.S. healthcare operations.

About the Role

PsychPlus is seeking a detail-oriented Prior Authorization Specialist to support authorization processes for U.S. healthcare services.

The specialist will coordinate with insurance companies, healthcare providers, and internal teams to obtain and maintain required authorizations. The role requires strong attention to detail, accurate documentation, timely follow-up, and familiarity with U.S. health insurance processes.

The ideal candidate has prior experience working with U.S. healthcare organizations and understands insurance authorization workflows.

Key Responsibilities

• Review patient and insurance information to determine prior authorization requirements
• Submit prior authorization requests to insurance companies and payer portals
• Gather and organize required clinical and administrative documentation
• Follow up with insurance companies regarding pending authorization requests
• Track authorization status, approval dates, expiration dates, and reference numbers
• Communicate authorization requirements and status updates to internal teams
• Identify missing information or documentation that could delay authorization
• Maintain accurate authorization records in applicable healthcare systems
• Research payer-specific authorization requirements and procedures
• Escalate delayed, denied, or complex authorization requests when appropriate
• Maintain accurate documentation of communications and authorization outcomes
• Meet established accuracy, productivity, and turnaround time expectations
• Protect confidential patient and healthcare information

Required Qualifications

• At least 1 year of experience in U.S. healthcare prior authorization, insurance verification, medical billing, or Revenue Cycle Management
• Working knowledge of U.S. health insurance processes
• Experience communicating with U.S. insurance companies or payer representatives
• Experience using payer portals or electronic authorization systems
• Strong written and verbal English communication skills
• Strong attention to detail and organizational skills
• Ability to manage multiple authorization requests and follow-up deadlines
• Proficiency with Microsoft Excel or Google Sheets
• Ability to work independently in a remote environment
• Availability to work Monday to Friday, 9:00 AM to 6:00 PM U.S. Central Time

Preferred Qualifications

• Experience with behavioral health, mental health, psychiatry, or other outpatient healthcare services
• Experience with prior authorization for commercial insurance, Medicare, or Medicaid
• Experience working with U.S. healthcare providers or medical billing companies
• Familiarity with EHR, EMR, practice management, or Revenue Cycle Management systems
• Experience working with CollaborateMD or similar healthcare billing systems
• Knowledge of CPT, ICD-10, and payer-specific authorization requirements

Why Join PsychPlus?

• Work remotely from the Philippines while supporting a growing U.S. healthcare organization
• Gain hands-on experience with U.S. healthcare operations and Revenue Cycle Management
• Work with U.S.-based healthcare and operations teams
• Develop expertise in insurance authorization and payer processes
• Opportunity for professional growth within a growing healthcare organization

Equal Opportunity Employer

PsychPlus is an Equal Opportunity Employer. Employment decisions are based on qualifications, experience, and business needs.

Work Location: Remote