Remote Insurance & Prior Authorization Specialist

Go Lean Health; General Trias; On-site; PHP 432,000 - 518,000; Part time

Benefits offered by this job

Remote work

Job summary

Go Lean Health is seeking a Back-Office Insurance & Prior Authorization Virtual Medical Assistant to support a US nonprofit behavioral health organization. The role focuses on administrative and insurance work to move patients through enrollment and prepare them for care, remotely from the Philippines.

This position emphasizes verification of eligibility, prior authorizations, and managing enrollment-related documentation.

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.

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.
• Initiate and process prior authorization requests according to payer and clinic requirements.
• Track pending authorization requests and follow them through approval, denial, or other resolution.
• Review patient information to determine potential nonprofit financial assistance eligibility.
• Support patient intake by setting up profiles and ensuring complete demographic and insurance data.
• Prepare patient charts and ensure required administrative documents are complete.
• Update records in AdvancedMD and coordinate with front-desk VMA.

Skills

Insurance verification

Prior authorization

EHR proficiency

English communication

Attention to detail

Tools

AdvancedMD

Microsoft Teams

Payer portals

Job description

Go Lean Health is seeking a Back-Office Insurance & Prior Authorization Virtual Medical Assistant to support a US nonprofit behavioral health organization. The role focuses on administrative and insurance work to move patients through enrollment and prepare them for care, remotely from the Philippines.

This position emphasizes verification of eligibility, prior authorizations, and managing enrollment-related documentation.