Remote Insurance Verification & Authorization Expert

Rockstar

Manila

On-site

PHP 3,061,849 - 4,286,589

Full time

14 days+

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Job summary

Rockstar is seeking a detail-oriented Insurance Verification & Authorization Specialist to support U.S.-based healthcare practices on a full-time remote basis. This role focuses on verifying patient insurance and obtaining prior authorizations, working closely with front office, billing, and clinical staff to ensure accurate coverage before appointments.

The ideal candidate will have 2+ years of experience in medical insurance verification, strong payer knowledge, and excellent English

Qualifications

2+ years of experience in medical insurance verification or related healthcare administrative role.
Strong working knowledge of insurance terminology, benefit structures, eligibility processes, and payer requirements.
Proven ability to interpret and communicate benefit details accurately to clinical staff and patients.
Experience working directly with insurance companies via phone and online payer portals.
High attention to detail and a track record of accuracy in data entry and documentation.
Excellent written and verbal English communication skills, clear phone communication is essential.
Ability to work independently, meet daily targets, and maintain consistent communication with client teams.
Reliable home office setup with a stable internet connection suitable for HIPAA-compliant remote work.

Responsibilities

Verify patient insurance eligibility and benefits prior to all scheduled appointments.
Confirm coverage details including co-pays, co-insurance, deductibles, out-of-pocket maximums, and coverage limitations.
Identify and document patient financial responsibility at least 24 hours before patient arrival.
Update patient files and EMR records with accurate, complete insurance and eligibility information.
Communicate verification results clearly to clinical and administrative staff.
Handle a broad range of insurance types including commercial plans, Medicare, Medicaid, workers' compensation, and auto claims.
Obtain prior authorizations for procedures, therapy visits, and services as required by insurance plans.
Submit authorization requests via phone, payer portals, and electronic systems in a timely manner.
Track authorization approvals, denials, pending requests, and expiration dates in an organized manner.
Follow up proactively on pending authorizations to prevent gaps in care or appointment cancellations.
Renew authorizations as ongoing treatment requires and maintain complete records of all authorization activity.
Escalate unresolved authorization issues to the appropriate internal team member promptly.
Liaise directly with insurance companies via phone and payer portals to clarify coverage, resolve discrepancies, and obtain benefit details.
Assist patients and clinical staff with insurance-related questions and benefit explanations.
Identify and help prevent claim rejections caused by inaccurate or incomplete insurance information.
Assist billing teams with insurance-related documentation, claim support, and records retrieval as needed.
Maintain accurate, organized electronic patient records and insurance documentation in the EMR.
Type, upload, and manage patient forms and insurance-related documents.
Process and organize incoming faxes, referrals, and payer correspondence.
Generate basic reports and tracking logs to support verification workflow oversight.
Maintain strict HIPAA compliance and patient confidentiality at all times.