Remote Insurance Verification & Authorization Specialist

Go Lean Health; Compostela; Remote; PHP 435,000 - 522,000; Full time

Job summary

Go Lean Health is seeking a Back-Office Insurance Specialist for remote work supporting a US nonprofit behavioral health organization. The role focuses on enrollment, eligibility, and authorization workflows with commercial plans, Medicaid, and nonprofit programs.

You will manage intake, credentialing support, and chart preparation while maintaining HIPAA-compliant documentation and coordinating with bilingual front-desk teams. This is a full-time, remote position with US time-zone alignment.

Qualifications

• Experience with insurance verification and prior authorizations.
• Experience working with US commercial insurance plans, Medicaid, or both.
• Strong understanding of healthcare eligibility and authorization workflows.
• Experience using an EHR or practice-management system.
• Strong administrative documentation and data-entry skills.
• Professional verbal and written English communication.

Responsibilities

• Verify patient eligibility and benefits with commercial insurance plans and Medicaid.
• Review payer information and document verification results 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 and authorization status.
• Track pending authorization requests through approval or denial.
• Review patient information to determine potential nonprofit financial assistance eligibility.
• Conduct outbound follow-up with patients for missing forms or information.
• Maintain documentation of eligibility status and coordinate with front-desk VMA when ready to schedule.
• Support patient intake by setting up profiles and collecting forms.
• Track patients through intake and enrollment and confirm completion before scheduling.
• Assist with provider credentialing and payer enrollment as needed.

Skills

Insurance verification

Prior authorizations

HIPAA compliance

EHR systems

Tools

AdvancedMD

Microsoft Teams

Payer portals

VPN

Time Doctor

Job description

Go Lean Health is seeking a Back-Office Insurance Specialist for remote work supporting a US nonprofit behavioral health organization. The role focuses on enrollment, eligibility, and authorization workflows with commercial plans, Medicaid, and nonprofit programs.

You will manage intake, credentialing support, and chart preparation while maintaining HIPAA-compliant documentation and coordinating with bilingual front-desk teams. This is a full-time, remote position with US time-zone alignment.