# Revenue Cycle & Authorizations Specialist - Podiatry Clinic

> Staffing for Doctors · Philippines (Remote) · — · Posted 2026-09-04

**Workplace:** remote

## Description

### Position Overview

We are seeking a detail-oriented, high-performing **Revenue Cycle & Authorizations Specialist** to manage patient eligibility, obtain prior authorizations, and drive accounts receivable (AR) recovery.

This role manages a core volume of approximately **200 claims per week**, with a primary focus on navigating and resolving complex claim denials, prior authorization hurdles, and payer issues associated with two major HMO plans. The ideal candidate thrives on problem-solving, possesses strong payer navigation skills, and excels at keeping practice revenues steady and predictable.

## Requirements

### Primary Responsibilities

### Accounts Receivable & Denials Management

-   Manage end-to-end follow-ups on unpaid, underpaid, and denied claims across accounts receivable (AR) aging reports.
-   Serve as the dedicated specialist for two high-priority HMO plans—actively researching rejection reasons, resubmitting corrected claims, filing appeals, and escalating administrative roadblocks.
-   Process routine Medicare and PPO denials swiftly to ensure low aging across simpler payer types.
-   Process, track, and reconcile approximately **200 claims per week**.

### Authorizations & Insurance Verification

-   Perform insurance eligibility and coverage verifications prior to patient appointments.
-   Submit, track, and secure prior authorizations from commercial and managed care payers to prevent coverage gaps and claim rejections.
-   Maintain clear communication with clinical staff regarding authorization statuses, limitations, and approval updates.

### Payer & Patient Communication

-   Place high-volume follow-up calls to HMO representatives, medical groups, and clearinghouses to clear claim holds.
-   Communicate politely and clearly with patients regarding insurance coverage rules, outstanding balances, or required authorization steps.

### Qualifications & Key Requirements

-   **Experience:** 2+ years of experience in medical billing, accounts receivable management, and insurance prior authorizations.
-   **HMO Expertise:** Strong working knowledge of HMO medical group referrals, capitation/FFS structures, and HMO-specific appeal pathways.
-   **Coding & Billing Knowledge:** Working knowledge of CPT, ICD-10, HCPCS codes, modifiers, and CMS-1500 claim formats.
-   **Volume Capability:** Proven ability to manage a consistent workload of ~200 claims per week without sacrificing accuracy.
-   **Reliability:** High level of punctuality and commitment to maintaining the established 38-hour weekly work schedule.

## Apply

[Apply at Staffing for Doctors](https://apply.workable.com/staffing-for-doctors/j/DDFB181E03/apply)

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