Jobs in Philippines

Healthcare Insurance Coordinator (Full-Time)

Schedule: 45 hours/week | 9:00 AM - 5:00 PM PST

Location: Fully Remote

We are seeking an experienced and detail-oriented Healthcare Insurance Coordinator to support our insurance verification and authorization processes. This role is ideal for someone with a strong background in U.S. healthcare insurance, who thrives in a structured, fast-paced, and compliance-driven environment.

1. Verification of Benefits (VOB)
   • Contact insurance providers to verify patient eligibility and coverage
   • Accurately document payer responses in internal systems
   • Flag missing or unclear information for internal review
   • Follow payer-specific guidelines (e.g., Medicaid vs. commercial insurance)
2. Initial Authorization Support
   • Review patient intake documents and treatment recommendations
   • Complete payer-specific authorization request forms
   • Assemble and submit packets with supporting documents (e.g., treatment plans, credentials)
   • Use payer portals, fax, or email to submit authorizations
   • Track confirmation statuses and log any necessary follow-ups
3. Treatment Re-Authorization
   • Review clinical documentation and ongoing treatment plans
   • Summarize clinical data in alignment with payer requirements
   • Ensure all documentation meets compliance standards (e.g., measurable goals)
   • Copy and format relevant data (e.g., CPT codes, session logs)
   • Coordinate with clinicians for clarification and missing details
   • Track submission timelines to avoid lapses in treatment approvals

• 4+ years of experience in U.S. healthcare insurance coordination or revenue cycle management
• Deep understanding of VOB, prior authorizations, and treatment re-authorizations
• Familiarity with payer guidelines, including Medicaid and commercial plans
• Experience working with insurance portals or healthcare systems
• High attention to detail and ability to handle sensitive patient data securely
• Excellent written and verbal communication skills in English
• Reliable internet connection and ability to work consistently 45 hours per week