Remote Insurance & Prior Authorization Specialist

GoLean Health; Philippines; On-site; PHP 672,000,000 - 806,400,000; 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. The role focuses on administrative and insurance tasks to move patients through enrollment and prepare them for care, handling audits, backlogs, and cross-functional support.

Responsibilities include verification of benefits, initiating authorizations, and maintaining accurate documentation in AdvancedMD, with an emphasis on

Qualifications

• Experience with US commercial insurance plans and Medicaid.

Responsibilities

• Verify patient eligibility and benefits with commercial insurance plans and Medicaid.
• Initiate and process prior authorization requests according to payer and clinic requirements.
• Review eligibility information and follow up on missing documents to enable enrollment.
• Update patient charts and insurance data in the EHR/practice-management system.
• Prioritize and manage backlog cases with clear documentation and next steps.
• Assist with credentialing and payer enrollment as needed.
• Coordinate with bilingual front-desk VMA for smooth patient flow.
• Develop and update SOPs for insurance verification, authorizations, and enrollment workflows.

Skills

Insurance verification

Prior authorizations

US payer knowledge

Payer portals

EHR proficiency

Data entry

HIPAA compliance

Attention to detail

Organization

Remote work

English communication

Tools

AdvancedMD

Microsoft Teams

Time Doctor

VPN

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. The role focuses on administrative and insurance tasks to move patients through enrollment and prepare them for care, handling audits, backlogs, and cross-functional support.

Responsibilities include verification of benefits, initiating authorizations, and maintaining accurate documentation in AdvancedMD, with an emphasis on