Remote Behavioral Health Insurance & Authorization Specialist

GoLean Health; Pasig; On-site; PHP 432,000 - 605,000; Full time

Job summary

GoLean Health is seeking a Back-Office Insurance & Prior Authorization Virtual Medical Assistant to support a nonprofit behavioral health organization in the United States. This role focuses on administrative and insurance tasks to move patients through enrollment and prepare them for care.

The clinic handles commercial insurance, Medicaid, self-pay, and nonprofit programs, requiring strong organization to determine needed documentation and follow-up for each case.

Qualifications

• Healthcare experience with insurance verification and prior authorizations.
• Experience with US commercial insurance and Medicaid.
• Experience contacting insurers 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.

Responsibilities

• Verify patient eligibility and benefits with commercial plans and Medicaid.
• Review payer information and document results in AdvancedMD and clinic systems.
• Identify insurance requirements or missing information affecting enrollment.
• Initiate and process prior authorization requests per payer and clinic requirements.
• Communicate with insurance representatives and use payer portals for requirements and statuses.
• Track pending authorization requests through approval or denial.
• Review patient information for nonprofit financial assistance eligibility.
• Conduct outbound follow-up with patients for missing forms or signatures.
• Maintain documentation of eligibility status and pending items.
• Support patient intake by setting up profiles and collecting forms.
• Coordinate with front-desk VMA to ensure enrollment steps are completed.
• Prepare patient charts before appointments and verify completeness.
• Assist with provider credentialing and payer enrollment as needed.
• Document and update SOPs for verification, authorization, and enrollment workflows.

Skills

Insurance verification

Prior authorization

English communication

EHR systems

HIPAA compliance

Multitasking

Tools

AdvancedMD

Payer portals

Job description

GoLean Health is seeking a Back-Office Insurance & Prior Authorization Virtual Medical Assistant to support a nonprofit behavioral health organization in the United States. This role focuses on administrative and insurance tasks to move patients through enrollment and prepare them for care.

The clinic handles commercial insurance, Medicaid, self-pay, and nonprofit programs, requiring strong organization to determine needed documentation and follow-up for each case.