Insurance Verification and Authorization Coordinator | On-site | Philippines

The Insurance Verification & Authorization Coordinator is responsible for validating patient insurance coverage, confirming eligibility for services, and obtaining required authorizations from insurance providers. The role serves as a liaison between Affirmed Home Care, insurance carriers, patients, and internal care teams to ensure services are approved, coverage requirements are met, and patient care can begin without administrative delays. 

Job Description:  

• Contact insurance carriers to verify patient eligibility and active coverage 
• Confirm benefit details, coverage limitations, co-pays, deductibles, and authorization requirements 
• Submit and track prior authorization requests for home healthcare services 
• Follow up with insurance companies regarding pending approvals and status updates 
• Document eligibility, authorization outcomes, and payer requirements accurately within designated systems 
• Communicate authorization status and coverage information to internal teams 
• Identify and escalate authorization delays, denials, or coverage concerns 
• Coordinate with intake, scheduling, operations, and clinical teams to support patient onboarding 
• Maintain payer-specific requirements and process documentation 
• Ensure compliance with HIPAA and established healthcare privacy standards 

Skills: 

• The role requires the candidate to be fluent in: 
• Medical terminology 
• Diagnoses and treatment plans 
• Home health terminology 
• Physician orders 
• Insurance language 
• Clinical documentation 

Knowledge/Abilities: 

• Successful candidates should demonstrate the ability to navigate insurance verification and authorization processes while communicating effectively with insurance providers, patients, and internal stakeholders. They must be comfortable reviewing coverage information, validating patient eligibility, tracking authorization requests, and accurately documenting payer requirements and outcomes. Strong attention to detail, critical thinking, and the ability to interpret healthcare terminology and insurance guidelines are essential. Candidates should be capable of managing multiple cases simultaneously, resolving coverage-related inquiries, and collaborating across operational and clinical teams to ensure timely patient onboarding and continuity of care

Working Conditions:  

• 100% in-center: Work on-site
• Frequent inbound and outbound customer communication 
• High-volume transaction processing environment 
• Standard business hours with flexibility based on operational requirement 

Education : 

• Nursing graduate (Licensed or Unlicensed) PHRN; preferably not required

Experience Target : 

• Healthcare administration experience 
• Medical billing experience 
• Prior authorization experience 
• Insurance verification experience 
• Home health, hospice, or healthcare support experience 
• Familiarity with U.S. healthcare terminology and insurance processes 
• Experience working with EMR, CRM, or healthcare systems 

Peak Support and our Work-from-Home PLUS model

At Peak Support, we are dedicated to providing exceptional service to our clients and an exceptional work environment for our team members.

We don’t do this with ping pong tables or video games. We do it by creating a positive, encouraging and performance-driven culture that enables our team members to build rewarding, long-term careers. We’re proud that our Glassdoor rating of 4.5 is the highest in the Business Process Outsourcing industry.

Peak Support offers all the convenience of working from home, with the benefits of working for an established organization with an exceptional team and tremendous opportunities for growth. Peak Support has been 100% remote since day one, so we have built a culture and a set of processes that support the success of our remote team members.