Prior Authorization Specialist (US Healthcare)

About Visaya KPO:



Visaya Knowledge Process Outsourcing Corporation is a proudly Filipino organization recognized globally for service excellence, innovation, and a culture of malasakit. We are committed to building long-term partnerships through quality, reliability, and a people-first approach.





Role Overview:



We are looking for a detail-oriented Prior Authorization Specialist to join our team. The ideal candidate will have experience in medical coding within the US healthcare system, whether certified or non-certified, and a strong background in medical management resolution.





Key Responsibilities:



Review and analyze medical records, claims, and documentation to resolve medical management and coding issues.



Collaborate with healthcare providers, coders, and payers to clarify documentation and ensure accurate coding and claim resolution.



Assist in resolving denials, d...