Insurance Verification & Authorization Specialist

Rockstar; Manila; Remote; PHP 3,790,000 - 5,685,000; Full time

Job summary

Rockstar is seeking a meticulous Insurance Verification & Authorization Specialist to support U.S.-based healthcare practices on a full-time remote basis. You will own verification workflows, work with front office and billing teams, and ensure patients are properly verified and authorized before appointments.

The role emphasizes accuracy, process discipline, and proactive follow-through to prevent denials and revenue loss while maintaining HIPAA compliance in a remote, full-time setting.

Qualifications

• 2+ years of experience in medical insurance verification or related healthcare administrative role.
• Strong working knowledge of insurance terminology, benefits structures, eligibility processes, and payer requirements.
• Proven ability to interpret and communicate benefit details accurately to clinical staff and patients.
• Experience working directly with insurance companies via phone and online payer portals.
• High attention to detail and accuracy in data entry and documentation.

Responsibilities

• 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 before arrival.
• Update EMR records with accurate insurance information.
• Communicate verification results to clinical and administrative staff.
• Handle diverse insurance types including commercial plans, Medicare, Medicaid, workers' compensation, and auto claims.
• Obtain prior authorizations for procedures and services as required.
• Submit authorization requests via phone, payer portals, and electronic systems.
• Track approvals, denials, pending requests, and expiration dates.
• Follow up on pending authorizations to prevent gaps in care.
• Renew authorizations as ongoing treatment requires.
• Escalate unresolved issues to the appropriate internal team.
• Liaise with insurance companies to clarify coverage and obtain details.
• Assist patients and staff with insurance questions and benefit explanations.
• Identify and help prevent claim rejections due to inaccurate information.
• Support billing with insurance documentation and records retrieval.
• Maintain HIPAA-compliant records and participate in team activities.

Skills

Insurance verification

Prior authorization

HIPAA compliance

Data entry accuracy

English communication

Tools

EMR platforms

Prompt

WebPT

Raintree

Job description

Insurance Verification & Authorization Specialist

Rockstar is an industry-leading staffing company based in Arizona that helps healthcare businesses across the United States streamline operations by connecting them with skilled remote professionals. We partner with talented individuals from around the world, providing meaningful remote career opportunities that empower personal and professional growth.

At Rockstar, we are committed to placing team members who not only meet our clients' operational needs but who also reflect our core values of integrity, excellence, and long-term service. Every placement is an opportunity to make a meaningful difference, for the practice, for patients, and for you.

Job Description

This is a remote position.

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
  

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
  
• 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