Remote Back-Office Insurance & Authorization Specialist

Go Lean Health; Makati; On-site; PHP 432,000 - 518,000; Full time

Job summary

Go Lean Health seeks a Back-Office Insurance & Prior Authorization Virtual Medical Assistant to support a nonprofit behavioral health organization. The role focuses on administrative and insurance tasks to move patients through enrollment and prepare them for care.

The candidate will verify eligibility, initiate prior authorizations, assess nonprofit financial assistance options, handle enrollment intake, and maintain accurate records in AdvancedMD.

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.

Responsibilities

• Verify patient eligibility and 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 enrollment.
• Initiate and process prior authorization requests according to payer and clinic requirements.
• Communicate with insurance representatives and use payer portals to obtain requirements and authorization status.
• Track pending authorization requests and follow them through approval, denial, or other resolution.
• Review patient information and documentation to determine nonprofit financial assistance eligibility.
• Conduct outbound follow-up with patients regarding missing forms, signatures, or enrollment requirements.
• Maintain documentation of eligibility status and pending requirements, coordinating with front-desk VMA for scheduling.

Skills

Insurance verification

Prior authorizations

EHR / PM systems

English communication

Attention to detail

Follow-up

Tools

AdvancedMD

Microsoft Teams

Time Doctor

Job description

Go Lean Health seeks a Back-Office Insurance & Prior Authorization Virtual Medical Assistant to support a nonprofit behavioral health organization. The role focuses on administrative and insurance tasks to move patients through enrollment and prepare them for care.

The candidate will verify eligibility, initiate prior authorizations, assess nonprofit financial assistance options, handle enrollment intake, and maintain accurate records in AdvancedMD.