Remote Insurance & Prior Authorization Specialist

GoLean Health; Cebu City; On-site; PHP 428,000 - 609,000; Part time

Job summary

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

You will verify eligibility, process prior authorizations, review benefits, assist with enrollment, and maintain accurate documentation in AdvancedMD and related systems.

Qualifications

• Experience verifying insurance eligibility and processing prior authorizations.
• Familiarity with US commercial insurance, Medicaid, and payer portals.
• Strong HIPAA knowledge and high attention to detail.

Responsibilities

• Verify patient eligibility and benefits with insurance plans and Medicaid.
• Initiate and process prior authorizations per payer and clinic rules.
• Review payer information and document results in AdvancedMD and systems.
• Identify missing information to enable enrollment progress.
• Assist with enrollment, intake, and chart preparation for scheduling.
• Support credentialing and payer enrollment activities as needed.
• Maintain accurate records of eligibility statuses and outreach.
• Coordinate with front-desk VMA for smooth transition to scheduling.

Skills

Insurance verification

Prior authorizations

HIPAA compliance

Data entry

English communication

Tools

AdvancedMD

Payer portals

EHR system

Job description

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

You will verify eligibility, process prior authorizations, review benefits, assist with enrollment, and maintain accurate documentation in AdvancedMD and related systems.