Patient Authorization Coordinator (Pharmacy Department CSR)

We are looking for a detail-oriented Patient Authorization Coordinatorto support our Pharmacy Department by managing patient insurance authorizations and ensuring timely access to prescribed medications and medical supplies. In this role, you will work closely with healthcare providers, insurance companies, pharmacy staff, patients, and internal teams to coordinate prior authorizations, verify insurance eligibility, and maintain accurate documentation.

The ideal candidate has strong communication skills, experience in healthcare or pharmacy support, and is comfortable working in a fast-paced environment while maintaining HIPAA compliance.

Requirements

• Verify patients' insurance eligibility and benefits.
• Process prior authorizations and re-authorizations for medications and medical supplies.
• Communicate with physicians' offices to obtain clinical documentation required for insurance approval.
• Submit authorization requests to insurance providers and follow up to ensure timely decisions.
• Maintain accurate patient records and document all interactions in the designated systems (e.g., Brightree, QS1, or other pharmacy management platforms).
• Monitor authorization expiration dates and create follow-up tasks to ensure uninterrupted patient care.
• Coordinate with pharmacy staff, healthcare providers, and insurance representatives to resolve authorization-related issues.
• Request interim medication or supply approvals when appropriate to prevent delays in patient treatment.
• Ensure compliance with payer guidelines, company policies, and HIPAA regulations.
• Perform other duties as assigned by the Operations Supervisor.

About You

• At least a High School Diploma or equivalent.
• At least 1 year of experience in a healthcare, pharmacy, medical prior authorization, insurance verification, or customer service role is preferred.
• Experience supporting pharmacy, PBM (Pharmacy Benefit Management), DME, or healthcare accounts is an advantage.
• Knowledge of insurance verification, prior authorization, or pharmacy claims processes is preferred.
• Familiarity with HIPAA regulations and handling Protected Health Information (PHI).
• Excellent verbal and written English communication skills.
• Strong attention to detail, organization, and time management skills.
• Ability to multitask and work efficiently in a fast-paced environment.
• Proficient in Microsoft Office applications and willing to learn pharmacy management systems.
• Willing to work onsite and on a night shift schedule.

Benefits

• HMO with 1 free dependent upon hire
• Life Insurance
• 20 PTO credits annually
• VL and SL cash conversion
• Annual Performance-Based Merit Increases and Employee Recognition
• Great Company Culture
• Career Growth and Learnings
• NIGHT SHIFT
• ONSITE (SM Clark or Makati)
• Php 28,000 - 32,500 all in