Insurance Verification & Authorization Specialist

Rockstar Global Careers; Colombia; Remote; COP 175,053,000 - 270,537,000; Full time

Job summary

Rockstar is seeking a detail-oriented Insurance Verification & Authorization Specialist to support U.S.-based healthcare practices on a full-time remote basis. This back-office role emphasizes accuracy and process discipline, ensuring verification and authorizations are completed before appointments.

You will own verification workflows, liaise with payers, and maintain EMR records to prevent denials and revenue loss. Collaboration across front office, billing, and clinical staff is essential.

Qualifications

• 2+ years in medical insurance verification, prior authorization, or related healthcare admin role.
• Strong knowledge of insurance terminology, benefits, eligibility, and payer requirements.
• Ability to communicate benefit details clearly to staff and patients.
• Experience with insurance companies via phone and payer portals.
• High attention to detail and accuracy in data entry and documentation.
• Excellent written and verbal English communication skills; clear phone communication essential.
• Strong organizational skills to manage high volumes of verifications and authorizations.

Responsibilities

• Verify patient insurance eligibility and benefits prior to scheduled appointments.
• Confirm coverage details including co-pays, deductibles, and out-of-pocket max.
• Identify and document patient financial responsibility at least 24 hours before arrival.
• Obtain prior authorizations for procedures as required by plans.
• Submit authorization requests via phone, payer portals, and electronic systems.
• Track approvals, denials, and expirations; follow up to prevent care gaps.
• Maintain EMR records with accurate insurance and eligibility information.
• Communicate verification results clearly to clinical and administrative staff.
• Liaise with insurance companies to clarify coverage and obtain benefit details.
• Assist billing teams with documentation and records retrieval as needed.

Skills

Attention to detail

English communication

HIPAA compliance

Independent work

Payer communications

Tools

EMR platforms

Job description

Rockstar is seeking a detail-oriented and experienced Insurance Verification & Authorization Specialist to support U.S.-based healthcare practices on a full-time remote basis. This is a specialized back-office role built for professionals who thrive on accuracy, process, and follow-through, and who understand that getting insurance right the first time directly protects patients and practices alike.

In this role, you will be the primary owner of insurance verification and prior authorization workflows, working closely with front office schedulers, billing teams, and clinical staff to ensure every patient is properly verified and authorized before their appointment. You will communicate regularly with insurance payers, maintain accurate records in the client's EMR system, and help prevent billing delays, denials, and revenue loss.

KEY RESPONSIBILITIES

Insurance Verification & Eligibility

• Verify patient insurance eligibility and benefits prior to all scheduled appointments
• Confirm coverage details including co-pays, co-insurance, deductibles, out-of-pocket maximums, and coverage limitations
• Identify and document patient financial responsibility at least 24 hours before patient arrival
• Update patient files and EMR records with accurate, complete insurance and eligibility information
• Communicate verification results clearly to clinical and administrative staff
• Handle a broad range of insurance types including commercial plans, Medicare, Medicaid, workers' compensation, and auto claims

Prior Authorization & Authorization Management

• Obtain prior authorizations for procedures, therapy visits, and services as required by insurance plans
• Submit authorization requests via phone, payer portals, and electronic systems in a timely manner
• Track authorization approvals, denials, pending requests, and expiration dates in an organized manner
• Follow up proactively on pending authorizations to prevent gaps in care or appointment cancellations
• Renew authorizations as ongoing treatment requires and maintain complete records of all authorization activity
• Escalate unresolved authorization issues to the appropriate internal team member promptly
• Liaise directly with insurance companies via phone and payer portals to clarify coverage, resolve discrepancies, and obtain benefit details
• Assist patients and clinical staff with insurance-related questions and benefit explanations
• Identify and help prevent claim rejections caused by inaccurate or incomplete insurance information
• Assist billing teams with insurance-related documentation, claim support, and records retrieval as needed

Payer Communication & Issue Resolution

• Liaise directly with insurance companies via phone and payer portals to clarify coverage, resolve discrepancies, and obtain benefit details
• Assist patients and clinical staff with insurance-related questions and benefit explanations
• Identify and help prevent claim rejections caused by inaccurate or incomplete insurance information
• Assist billing teams with insurance-related documentation, claim support, and records retrieval as needed

Documentation & Administrative Support

• Maintain accurate, organized electronic patient records and insurance documentation in the EMR
• Type, upload, and manage patient forms and insurance-related documents
• Process and organize incoming faxes, referrals, and payer correspondence
• Generate basic reports and tracking logs to support verification workflow oversight
• Maintain strict HIPAA compliance and patient confidentiality at all times
• Participate in team meetings, training sessions, and check-ins as required by the client

Requirements

Required

• 2+ years of experience in medical insurance verification, prior authorization, or a related healthcare administrative role
• Strong working knowledge of insurance terminology, benefit structures, eligibility processes, and payer requirements
• Proven ability to interpret and communicate benefit details accurately to both clinical staff and patients
• Experience working directly with insurance companies via phone and online payer portals
• High attention to detail and a track record of accuracy in data entry and documentation
• Excellent written and verbal English communication skills, clear phone communication is essential
• Strong organizational skills with the ability to manage high volumes of verifications and authorizations simultaneously
• Ability to work independently, meet daily targets, and maintain consistent communication with client teams
• Reliable home office setup with a stable internet connection suitable for HIPAA-compliant remote work

Preferred

• Experience supporting U.S.-based outpatient healthcare clinics: physical therapy, occupational therapy, speech therapy, or similar specialties
• Familiarity with common healthcare EMR platforms (e.g., Prompt, WebPT, Raintree, or similar)
• Experience handling Medicare, workers' compensation, and auto insurance claims
• Background in multi-location or high-volume clinic environments
• Comfort with Google Workspace, Slack, or other cloud-based communication and productivity tools

WHAT WE LOOK FOR

• Precision: you catch errors before they become denials, and you take pride in doing it right the first time
• Proactive follow-through: you track open items, follow up without being reminded, and close the loop
• Clear communication: you can explain a complex benefit structure to a patient or a clinic staff member with equal clarity
• Reliability: your client team counts on your daily output, you show up, you deliver, and you flag issues early
• Adaptability: insurance workflows vary by payer and by practice, you learn quickly and adjust without frustration

Benefits

• Competitive salary commensurate with experience
• Opportunities for professional development and long-term career growth
• Work within a dynamic, collaborative, and supportive team environment
• Stable, full-time remote employment with U.S.-based healthcare clients
• Make a meaningful impact by ensuring patients receive the care they need without insurance barriers