Remote Insurance & Prior Authorization Specialist

GoLean Health; Karachi Division; On-site; PKR 1,911,000 - 2,293,000; Part time

Job summary

GoLean Health is seeking an experienced Back-Office Insurance & Prior Authorization Virtual Medical Assistant to support a nonprofit behavioral health organization in the United States. This remote role handles administrative and insurance tasks to move patients through enrollment and prepare them for care.

You will verify eligibility, initiate prior authorizations, review payer requirements, and document results in AdvancedMD and related systems.

Qualifications

• Previous healthcare experience with insurance verification and prior authorizations.
• Experience with US commercial insurance plans and Medicaid.
• Experience using payer portals and healthcare EHRs.
• Knowledge of HIPAA and patient confidentiality requirements.

Responsibilities

• Verify patient eligibility and benefits with commercial plans and Medicaid.
• Review payer information and document verification results in clinic systems.
• Identify missing information affecting enrollment progress.
• Initiate and process prior authorization requests.
• Communicate with insurance representatives and track authorization status.
• Follow up on pending authorizations through to resolution.
• Review documentation to determine potential eligibility for nonprofit financial assistance.
• Conduct outbound follow-up for missing forms or information.
• Coordinate with front-desk VMA to schedule after enrollment.
• Update patient demographics, insurance info, authorization details, and financial eligibility in AdvancedMD.
• Prepare patient charts before appointments and ensure documents are complete.
• Resolve incomplete information before scheduled visits.
• Review outstanding cases, prioritize by urgency, and take next actions.
• Document outreach attempts and next steps until resolution.
• Assist with provider credentialing and payer enrollment as needed.
• Organize credentialing documents and renewal information.
• Follow up on pending items with the clinic team.
• Provide cross-functional administrative support and ensure smooth patient flow.
• Coordinate with bilingual front-desk VMA for enrollment and scheduling transitions.
• Develop and update SOPs for verification, authorizations, and enrollment.
• Identify bottlenecks and suggest process improvements to increase accuracy and turnaround.

Skills

Insurance verification

Prior authorizations

HIPAA compliance

EHR systems

Data entry

English communication

Organization

Follow-up

Multitasking

Tools

AdvancedMD

Microsoft Teams

Payer portals

VPN/_secure remote-access

Time Doctor

Job description

GoLean Health is seeking an experienced Back-Office Insurance & Prior Authorization Virtual Medical Assistant to support a nonprofit behavioral health organization in the United States. This remote role handles administrative and insurance tasks to move patients through enrollment and prepare them for care.

You will verify eligibility, initiate prior authorizations, review payer requirements, and document results in AdvancedMD and related systems.