Remote Insurance & Enrollment Specialist

Go Lean Health; Philippines; Remote; PHP 431,000 - 517,000; Part time

Job summary

Go Lean Health is seeking a Back-Office Insurance & Prior Authorization Virtual Medical Assistant to support a nonprofit behavioral health organization in the United States. The role focuses on insurance verification, authorizations, enrollment, and building reliable back-office processes for growth.

You will handle enrollment steps, eligibility checks, and coordination with payer portals, EHRs, and front-desk VMA to keep cases moving toward scheduling.

Qualifications

• Previous healthcare experience with insurance verification and prior authorizations.
• Experience with US commercial insurance plans and Medicaid.
• 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.
• Professional verbal and written English communication.
• Ability to work independently and manage multiple pending cases.
• Strong understanding of HIPAA and patient confidentiality requirements.
• Reliable attendance and punctuality.

Responsibilities

• Verify patient eligibility and applicable 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, authorization status, and supporting information.
• Track pending authorization requests and follow them through approval, denial, or other appropriate resolution.
• Review patient information and required documentation to determine potential eligibility for nonprofit financial assistance or reduced-cost programs.
• Conduct outbound follow-up with patients regarding missing forms, insurance information, signatures, or other incomplete enrollment or eligibility requirements.
• Maintain accurate documentation of eligibility status and pending requirements, and coordinate with the front‑desk VMA once the patient is ready to proceed toward scheduling.
• Support patient intake by setting up patient profiles and portals, collecting required forms, and ensuring demographics and insurance information are complete.
• Review intake documentation for missing or incomplete information and conduct outbound follow-up with patients to obtain required forms, signatures, insurance details, or other enrollment requirements.
• Track each patient through the intake and enrollment process, coordinate with the front‑desk VMA, and confirm all steps before scheduling.
• Assist with provider insurance credentialing and payer enrollment as the clinic expands.
• Organize credentialing documents and follow up on pending items.
• Update patient demographics, insurance information, authorization details, and related records in AdvancedMD.
• Prepare patient charts before appointments and ensure required documents are ready.
• Identify incomplete information and resolve or escalate issues before visits.
• Review backlog and prioritize cases by urgency and status.
• Coordinate with payer or internal teams to clear blockers.
• Document outreach and next steps until case resolution.
• Provide cross-functional administrative support and SOP updates.
• Assist with training and process documentation.

Skills

Insurance verification

Prior authorizations

English communication

HIPAA compliance

Organization

Data entry

Attention to detail

Follow-up

EHR experience

Payer portals

Team coordination

Tools

AdvancedMD

Microsoft Teams

VPN

Time Doctor

Job description

Go Lean Health is seeking a Back-Office Insurance & Prior Authorization Virtual Medical Assistant to support a nonprofit behavioral health organization in the United States. The role focuses on insurance verification, authorizations, enrollment, and building reliable back-office processes for growth.

You will handle enrollment steps, eligibility checks, and coordination with payer portals, EHRs, and front-desk VMA to keep cases moving toward scheduling.