Bilingual Back-Office Insurance & Prior Authorization

Go Lean Health; Sur; Remote; COP 25,776,000 - 36,712,000; Part time

Job summary

Go Lean Health seeks a Bilingual Back-Office Insurance & Prior Authorization Virtual Medical Assistant to support enrollment and care preparation for a US nonprofit behavioral health organization. The role emphasizes administrative tasks, insurance verification, and authorization processes in a remote setting.

Responsibilities include ensuring eligibility, handling prior authorizations, coordinating patient intake, and tracking enrollment steps while maintaining HIPAA-compliant documentation and

Qualifications

• Healthcare experience with insurance verification and prior authorizations.
• Experience with US commercial insurance and Medicaid.
• Experience using payer portals.
• Knowledge of eligibility and authorization workflows.
• Experience with EHR or practice-management systems.
• Strong admin documentation and data-entry skills.
• High attention to detail with good follow-up and organization.
• Ability to work independently on multiple cases.
• Understanding of HIPAA and patient confidentiality requirements.
• Reliable attendance and punctuality.

Responsibilities

• Verify patient eligibility and applicable benefits with commercial plans and Medicaid.
• Review payer information and document results in clinic systems.
• Identify missing information that could delay enrollment.
• Initiate and process prior authorization requests per requirements.
• Communicate with insurance representatives and use payer portals for status.
• Track pending authorizations through approval or denial.
• Support patient intake by setting up profiles and collecting forms.
• Review intake docs for completeness and follow up with patients.
• Track patients through enrollment and coordinate with front-desk VMA.
• Review eligibility for nonprofit assistance or reduced-cost programs.
• Maintain documentation of eligibility status and pending items.
• Assist with provider credentialing and payer enrollment.

Skills

Insurance verification

Prior authorizations

EHR systems

Data entry

HIPAA compliance

Attention to detail

Remote work

Tools

AdvancedMD

Microsoft Teams

Payer portals

VPN

Intake portals

Time Doctor

Phone systems

Job description

Bilingual Back-Office Insurance & Prior Authorization

Remote | Behavioral Health | 30 hours/week | $7/Hour
Working Hours: 11:00 AM to 7:00 PM US Central Time

Role Overview

We are seeking an experienced Bilingual Back-Office Insurance & Prior Authorization Virtual Medical Assistant to support a nonprofit behavioral health organization in the United States.

This position will focus primarily on the administrative and insurance-related work required to move patients successfully through enrollment and prepare them for care.

The clinic serves patients using multiple payer arrangements, including commercial insurance, Medicaid, self-pay, and nonprofit programs that may reduce or eliminate the patient's cost of care. Because each patient may require a different process, the successful candidate must be highly organized and capable of determining what documentation, eligibility verification, authorization, or follow-up is needed for each case.

You will also help address existing administrative backlogs and build reliable back-office processes that the organization can continue using as it grows.

Key Responsibilities

Insurance Verification & Benefits

• Verify patient eligibility and applicable benefits with commercial insurance plans and Medicaid.

• Review payer information and document verification results accurately in AdvancedMD and related clinic systems.

• Identify insurance requirements, coverage issues, or missing information that could prevent a patient from progressing through enrollment.

Prior Authorizations

• Initiate and process prior authorization requests according to payer and clinic requirements.

• Communicate with insurance representatives and use payer portals to obtain requirements, authorization status, and supporting information.

• Track pending authorization requests and follow them through approval, denial, or other appropriate resolution.

Patient Care Coordination, Intake & Enrollment

• Support patient intake by setting up patient profiles and portals, collecting required forms, and ensuring demographic and insurance information is complete and accurately documented.

• Review intake documentation for missing or incomplete information and conduct outbound follow-up with patients to obtain required forms, signatures, insurance details, or other enrollment requirements.

• Track each patient through the intake and enrollment process, coordinate with the front-desk VMA, and confirm that all required administrative steps are completed before the patient proceeds to scheduling.

Financial Eligibility & Patient Follow-Up

• Review patient information and required documentation to determine potential eligibility for nonprofit financial assistance or reduced-cost programs.

• Conduct outbound follow-up with patients regarding missing forms, insurance information, signatures, or other incomplete enrollment or eligibility requirements.

• Maintain accurate documentation of eligibility status and pending requirements, and coordinate with the front-desk VMA once the patient is ready to proceed toward scheduling.

Provider Credentialing Support

• Assist with provider insurance credentialing and payer enrollment as the clinic expands the scope of the position.

• Organize required credentialing documents, payer correspondence, application statuses, and renewal information.

• Follow up on pending credentialing items and communicate outstanding requirements to the appropriate clinic team member.

Required Qualifications

• Previous healthcare experience with substantial responsibility for insurance verification and prior authorizations.

• Experience working with US commercial insurance plans, Medicaid, or both.

• Experience contacting insurance companies and using payer portals.

• Strong understanding of healthcare eligibility and authorization workflows.

• Experience using an EHR or practice-management system.

• Strong administrative documentation and data-entry skills.

• High attention to detail and accuracy. Strong follow-up, organization, and task-management skills.

• Ability to work independently and manage multiple pending cases.

• Strong understanding of HIPAA and patient confidentiality requirements.

• Reliable attendance and punctuality.

Preferred Qualifications

• Behavioral health or mental health administrative experience.

• Experience with AdvancedMD.

• Experience evaluating patient financial eligibility.

• Experience supporting Medicaid populations.

• English and Spanish bilingual proficiency.

Systems & Tools

The clinic uses or expects the VMA to work with:

• AdvancedMD

• Microsoft Teams

• Phone services

• Insurance payer portals

• Patient intake portals and online forms

• VPN and secure remote-access systems

• Time Doctor

Remote Work Requirements

Candidates must maintain:

• Private and secure home workspace

• Reliable computer capable of supporting healthcare applications and multiple browser-based systems

• Stable primary internet connection, reliable backup internet

• Verified backup power source

• Professional headset

• Secondary monitor

• Quiet working environment appropriate for patient and insurance calls