Remote Medical Insurance & Authorization Specialist

Go Lean Health; Compostela; Remote; PHP 431,000 - 614,000; Full time

Benefits offered by this job

Remote work

30 hours/week

US nonprofit organization

Job summary

Go Lean Health is seeking a Back-Office Insurance & Prior Authorization Virtual Medical Assistant to support a US nonprofit behavioral health organization from Cebu City, Philippines. The role focuses on administrative and insurance workflows to move patients through enrollment and toward care.

You'll verify eligibility, obtain authorizations, review payer requirements, manage enrollment documentation, and help reduce backlogs while building scalable back-office processes for growth.

Qualifications

• Experience with insurance verification and prior authorizations.
• Experience with US commercial insurance plans and Medicaid.
• 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.
• 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 plans and Medicaid.
• Review payer information and document results in clinic systems.
• Identify insurance requirements or missing information that could delay enrollment.
• Initiate and process prior authorization requests.
• Communicate with insurance representatives and use payer portals.
• Track pending authorization requests and follow through to resolution.
• Review eligibility for nonprofit financial assistance or reduced-cost programs.
• Follow up with patients for missing forms and information.
• Maintain documentation of eligibility status and coordinate with front-desk VMA.
• Set up patient profiles and enrollment materials; ensure documentation is complete.
• Review intake documentation for missing information and follow up with patients.
• Track patients through intake to scheduling and coordinate with front-desk VMA.
• Assist with provider credentialing and payer enrollment.
• Prepare patient charts and ensure documents are complete.
• Update AdvancedMD records and related administrative data.
• Identify bottlenecks and propose process improvements.

Skills

Insurance verification

Prior authorizations

Healthcare administration

HIPAA compliance

EHR proficiency

Attention to detail

Tools

AdvancedMD

Microsoft Teams

Payer portals

Job description

Go Lean Health is seeking a Back-Office Insurance & Prior Authorization Virtual Medical Assistant to support a US nonprofit behavioral health organization from Cebu City, Philippines. The role focuses on administrative and insurance workflows to move patients through enrollment and toward care.

You'll verify eligibility, obtain authorizations, review payer requirements, manage enrollment documentation, and help reduce backlogs while building scalable back-office processes for growth.