Remote Insurance Verification & Prior Authorization Specialist

Go Lean Health; Cavite City; Remote; PHP 431,000 - 517,000; Full time

Job summary

Go Lean Health in the United States seeks a Back-Office Insurance & Prior Authorization Virtual Medical Assistant to support a nonprofit behavioral health organization. The role focuses on administrative and insurance tasks to move patients through enrollment and prepare them for care.

You will handle enrollment documentation, verify eligibility, obtain authorizations, and build reliable back-office processes for growth while addressing backlogs and coordinating with front-desk VMA for

Qualifications

• Previous healthcare experience with substantial responsibility for insurance verification and prior authorizations.
• Experience 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.
• Strong administrative documentation and data-entry skills.
• High attention to detail and accuracy.
• Strong follow-up, organization, and task-management skills.
• Professional verbal and written English communication.
• Ability to work independently and manage multiple pending cases.
• Strong understanding of HIPAA and patient confidentiality requirements.
• Reliable attendance and punctuality.

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.
• 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 and follow them through approval, denial, or other resolution.
• Review patient information to determine potential eligibility for nonprofit financial assistance or reduced-cost programs.
• Conduct outbound follow-up with patients regarding missing forms and insurance details.
• Maintain documentation of eligibility status and pending requirements; coordinate with front‑desk VMA.
• Support patient intake by setting up profiles and ensuring complete documentation.
• Review intake documentation for missing information and follow up for required items.
• Track each patient through intake to scheduling and confirm all steps are completed.
• Assist with provider credentialing and payer enrollment as needed.
• Update patient demographics, insurance information, and authorization details in AdvancedMD.
• Prepare patient charts before appointments and ensure completeness.

Skills

Insurance verification

Prior authorizations

Healthcare administration

Data entry

English communication

Tools

AdvancedMD

Microsoft Teams

Payer portals

VPN

Time Doctor

Job description

Go Lean Health in the United States seeks a Back-Office Insurance & Prior Authorization Virtual Medical Assistant to support a nonprofit behavioral health organization. The role focuses on administrative and insurance tasks to move patients through enrollment and prepare them for care.

You will handle enrollment documentation, verify eligibility, obtain authorizations, and build reliable back-office processes for growth while addressing backlogs and coordinating with front-desk VMA for