Remote Insurance Verification & Authorization Specialist

Rockstar; Manila; Remoto; PHP 3.790.000 - 5.685.000; Tempo pieno

Descrizione del lavoro

Rockstar is seeking a meticulous Insurance Verification & Authorization Specialist to support U.S.-based healthcare practices on a full-time remote basis. You will own verification workflows, work with front office and billing teams, and ensure patients are properly verified and authorized before appointments.

The role emphasizes accuracy, process discipline, and proactive follow-through to prevent denials and revenue loss while maintaining HIPAA compliance in a remote, full-time setting.

Competenze

• 2+ years of experience in medical insurance verification or related healthcare administrative role.
• Strong working knowledge of insurance terminology, benefits 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 accuracy in data entry and documentation.

Mansioni

• 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 before arrival.
• Update EMR records with accurate insurance information.
• Communicate verification results to clinical and administrative staff.
• Handle diverse insurance types including commercial plans, Medicare, Medicaid, workers' compensation, and auto claims.
• Obtain prior authorizations for procedures and services as required.
• Submit authorization requests via phone, payer portals, and electronic systems.
• Track approvals, denials, pending requests, and expiration dates.
• Follow up on pending authorizations to prevent gaps in care.
• Renew authorizations as ongoing treatment requires.
• Escalate unresolved issues to the appropriate internal team.
• Liaise with insurance companies to clarify coverage and obtain details.
• Assist patients and staff with insurance questions and benefit explanations.
• Identify and help prevent claim rejections due to inaccurate information.
• Support billing with insurance documentation and records retrieval.
• Maintain HIPAA-compliant records and participate in team activities.

Conoscenze

Insurance verification

Prior authorization

HIPAA compliance

Data entry accuracy

English communication

Strumenti

EMR platforms

Prompt

WebPT

Raintree

Descrizione del lavoro

Rockstar is seeking a meticulous Insurance Verification & Authorization Specialist to support U.S.-based healthcare practices on a full-time remote basis. You will own verification workflows, work with front office and billing teams, and ensure patients are properly verified and authorized before appointments.

The role emphasizes accuracy, process discipline, and proactive follow-through to prevent denials and revenue loss while maintaining HIPAA compliance in a remote, full-time setting.