Remote Back-Office Insurance & Credentialing Specialist

GoLean Health; Makati; Remote; PHP 488,000 - 585,000; Full time

Job summary

GoLean Health is seeking a Back-Office Insurance & Prior Authorization Virtual Medical Assistant to support a United States nonprofit behavioral health organization. This remote role focuses on administrative tasks, insurance verification, enrollment support, and back‑office process improvements.

You will work with various payer types, including commercial insurance and Medicaid, to move patients through enrollment and toward care while maintaining accurate records and timely follow-up.

Qualifications

• Experience with US commercial insurance plans and Medicaid.
• Experience using payer portals and communicating with insurers.
• Strong understanding of eligibility and authorization workflows.
• Experience with an EHR or practice-management system.
• Professional verbal and written English communication.

Responsibilities

• Verify patient eligibility and benefits with commercial plans and Medicaid.
• Initiate and process prior authorization requests as required.
• Review documentation and determine financial eligibility for nonprofit programs.
• Assist with patient intake and enrollment, ensuring complete records.
• Support provider credentialing and payer enrollment tasks as the clinic expands.
• Update patient charts with insurance and authorization details in the EMR.
• Review and progress backlog cases, prioritizing urgent items.
• Provide cross-functional administrative support and training where needed.
• Help document and update SOPs for insurance verification and enrollment workflows.

Skills

Insurance verification

Prior authorizations

English communication

AdvancedMD

Tools

AdvancedMD

Job description

GoLean Health is seeking a Back-Office Insurance & Prior Authorization Virtual Medical Assistant to support a United States nonprofit behavioral health organization. This remote role focuses on administrative tasks, insurance verification, enrollment support, and back‑office process improvements.

You will work with various payer types, including commercial insurance and Medicaid, to move patients through enrollment and toward care while maintaining accurate records and timely follow-up.