Insurance Verification and Authorization (IV/Auth) Specialist

Job Title: Insurance Verification and Authorization (IV/Auth) Specialist

Huron Target Start Date: May 4, 2026 (4 FTEs)

Huron Sign On Bonus: Not applicable (Reconfirm with Huron/CI)

Huron JD notes per email thread: Huron PH Job Descriptions (Updated) – sent by Dexter DCosta, 25 December 2026

12/24/25 DD: Reviewed and finalised - added date to file name.

External Job Title: Insurance Verification and Authorization (IV/Auth) Specialist

Capability: Healthcare

Business Unit: Huron Managed Services

Level:

Reports To: Supervisor/Manager/Director, Authorization

Work Location: Microsourcing Office, Taguig, Philippines

Work Shift: PH Night

POSITION SUMMARY:

Huron helps its clients drive growth, enhance performance, and sustain leadership in the markets they serve. We help healthcare organizations build innovation capabilities and accelerate key growth initiatives, enabling organizations to own the future, instead of being disrupted by it. Together, we empower clients to create sustainable growth, optimize internal processes, and deliver better consumer outcomes. Health systems, hospitals, and medical clinics are under immense pressure to improve clinical outcomes and reduce the cost of providing patient care. Investing in new partnerships, clinical services, and technology is not enough to create meaningful and substantive change. To succeed in the long-term, healthcare organizations must empower leaders, clinicians, employees, affiliates, and communities to build cultures that foster innovation to achieve the best outcomes for patients. Joining the Huron team means you will help our clients evolve and adapt to the rapidly changing healthcare environment and optimize existing business operations, improve clinical outcomes, create a more consumer-centric healthcare experience, and drive physician, patient, and employee engagement across the enterprise.

Excellent communication skills, attention to detail, and strong analytical and problem-solving abilities are essential for success in this role.

KEY RESPONSIBILITES:

Insurance Verification

Verify insurance and benefit eligibility for patient services

Authorization

Review clinical documentation and insurance guidelines to determine authorization requirements

May be responsible for verifying authorizations obtained by provider offices are accurate including correct CPT code, patient demographics, and effective dates cover the scheduled service date

May be responsible for obtaining authorizations for scheduled services from insurance or third parties as necessary to financially secure services

Ensure timely submission and follow-up of prior authorization requests to meet turnaround time (TAT) expectations

Identify and escalate authorization denials or delays in authorization to the appropriate team (e.g., Patient Access, Billing, etc.)

May be responsible for notification of admission as required by payers

May need to review medical necessity criteria and payer-specific guidelines

Payer and Patient outreach and communication

Perform outbound calls and online inquiries to insurance companies, providers, and patients to verify eligibility and to initiate and follow up on prior authorization requests

Handle inbound calls from U.S.-based and providers, demonstrating effective communication skills, empathy, and familiarity with healthcare or revenue cycle management processes

Coordinate with physician offices and clinical teams to obtain missing documentation

Documentation

Accurately enter and update authorization, eligibility, benefit, and patient demographic details in the client system (e.g., Epic, Meditech, Cerner)

Documents all payer communication and account activity according to defined standards

Maintain high level of confidentiality, professionalism, and compliance with HIPAA and other regulatory standards to protect patient information

Adhere to the IV/Auth quality and productivity standards established by the organization

Other duties and responsibilities as assigned.

QUALIFICATIONS:

Insurance Verification/Authorization Experience: At least one year of US Healthcare industry experience completing insurance verification and authorization activities

Education: Senior High School Diploma

Software Knowledge: Experience with an electronic medical record (EMR) system (e.g., Epic, Cerner, Meditech, etc.)

Strong understanding of insurance verification processes and benefit determination

Familiarity with payer portals and insurance websites for checking authorization and eligibility status

Proficiency in MS Office Standard Tools (Word, Outlook, Excel, etc.)

Soft Skills

Demonstrated ability to prioritize amid competing priorities

Strong ability to analyze raw data, draw conclusions, and develop actionable recommendations

Proven ability to adapt quickly to new and changing technical environments

Ability to pay close attention to details; strong follow-up and follow-through skills

Regularly makes complex decisions within the scope of the position, and is comfortable working independently

Independent judgment, discretion, and decision-making abilities

Demonstrates teamwork and integrity in all work-related activities

Ability to interact with internal and external customers in a professional manner

Strong analytical and critical thinking skills

Knows, understands, incorporates, and demonstrates Huron's Vision, and Values in behaviors, practices, and decisions

Authorization Experience: Two or more years of US Healthcare industry experience completing insurance verification and authorization activities

Education: Philippine bachelor's degree or equivalent preferred

RCM Knowledge: Knowledge of CPT and ICD-10 coding

IV/Auth Key Performance Indicators (KPIs) - Expectations

Meets 100% of productivity standards, as defined by the organization (e.g., completed and documented work on 40 accounts each day). Varies by client.

Meets Quality Review/Audit standards, as defined by the organization. Varies by client (e.g., 9.0/10 quarterly quality review score). Varies by client.