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Insurance Verification Specialist – Prior Authorizations
Location
Philippines
Posted
1 day ago
Salary
$5 - $6 / hour
Seniority
Mid Level
Job Description
Insurance Verification Specialist – Prior Authorizations
Winning Assistants LLC
• Verify patient insurance eligibility and benefits before scheduled appointments. • Review deductibles, copays, coinsurance, and patient financial responsibility. • Ensure insurance information is accurate and updated within the EHR/EMR. • Document all eligibility verification activities accurately and thoroughly. • Submit and obtain prior authorizations through insurance portals and payer websites. • Monitor pending authorization requests and follow up with insurance companies as needed. • Communicate authorization updates promptly to providers and clinic staff. • Maintain accurate records of authorization status and supporting documentation. • Create new patient charts and update existing medical records. • Ensure patient demographics and insurance information remain complete and accurate. • Maintain organized documentation within the electronic medical record system. • Answer overflow inbound phone calls when the in-office team is unavailable. • Assist patients with general inquiries in a courteous, professional, and empathetic manner. • Route calls appropriately and ensure timely message delivery. • Support the front office with insurance-related administrative tasks. • Maintain strict HIPAA compliance and protect patient confidentiality at all times.
Job Requirements
- Minimum 2 years of experience working in a U.S. healthcare setting.
- Hands-on experience with insurance eligibility verification and prior authorization processing.
- Strong understanding of:
- Commercial insurance plans
- Deductibles
- Copays
- Coinsurance
- Authorization requirements
- Experience using insurance portals and payer websites.
- Experience working with EHR/EMR systems (EasyDerm experience is a plus).
- Previous experience handling inbound patient phone calls in a medical office.
- Excellent English verbal and written communication skills with a professional phone presence.
- Preferred Qualifications: Experience working in a dermatology or other specialty medical practice.
- Previous experience as a remote Healthcare Virtual Assistant.
- Spanish-speaking ability is an advantage but not required.
Benefits
- Dedicated HR & Contractor Support Team: Access to world-class support for questions, guidance, contract matters, and client communication.
- Premium VPN Access (Optional): A secure VPN license can be provided upon request to enhance privacy and security for client-related tasks.
- HIPAA & Cybersecurity Training + Certification (Provided): Access to our internal HIPAA compliance training, cybersecurity modules, and certification to help you confidently handle PHI for U.S. healthcare clients.
- Top 1% VA Performance Training: Access to our proprietary training on communication, client management, productivity systems, and best practices to help you become a top-performing VA and increase long-term client retention.
- Client-Approved U.S. Holidays: Contractors may take U.S. holidays off according to the client’s needs and schedule.
- Client-Approved Paid or Unpaid Time Off: Time off may be granted by your client. Paid time off is optional and only if offered by the client.
- Access to Tools & Resources: Templates, workflow guides, productivity tools, and client-specific SOP support to help you perform at your best.
- Optional Performance-Based Incentives: Some clients may offer bonuses, incentives, or increased hours based on your performance.
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Role Description We are seeking an experienced Insurance Verification Specialist with a strong background in insurance eligibility verification, prior authorizations, and front office support. This role is ideal for someone who thrives in a fast-paced medical environment, enjoys working with insurance processes, and delivers exceptional patient service over the phone. The ideal candidate has hands-on experience navigating U.S. insurance portals, verifying patient benefits, obtaining prior authorizations, and supporting front office operations while maintaining the highest level of professionalism and HIPAA compliance. Key Responsibilities - Insurance Eligibility & Benefits Verification - Verify patient insurance eligibility and benefits before scheduled appointments. - Review deductibles, copays, coinsurance, and patient financial responsibility. - Ensure insurance information is accurate and updated within the EHR/EMR. - Document all eligibility verification activities accurately and thoroughly. - Prior Authorizations - Submit and obtain prior authorizations through insurance portals and payer websites. - Monitor pending authorization requests and follow up with insurance companies as needed. - Communicate authorization updates promptly to providers and clinic staff. - Maintain accurate records of authorization status and supporting documentation. - Patient Chart Management - Create new patient charts and update existing medical records. - Ensure patient demographics and insurance information remain complete and accurate. - Maintain organized documentation within the electronic medical record system. - Front Office & Patient Support - Answer overflow inbound phone calls when the in-office team is unavailable. - Assist patients with general inquiries in a courteous, professional, and empathetic manner. - Route calls appropriately and ensure timely message delivery. - Support the front office with insurance-related administrative tasks. - Maintain strict HIPAA compliance and protect patient confidentiality at all times. Qualifications - Minimum 2 years of experience working in a U.S. healthcare setting. - Hands-on experience with insurance eligibility verification and prior authorization processing. - Strong understanding of: - Commercial insurance plans - Deductibles - Copays - Coinsurance - Authorization requirements - Experience using insurance portals and payer websites. - Experience working with EHR/EMR systems (EasyDerm experience is a plus). - Previous experience handling inbound patient phone calls in a medical office. - Excellent English verbal and written communication skills with a professional phone presence. Preferred Qualifications - Experience working in a dermatology or other specialty medical practice. - Previous experience as a remote Healthcare Virtual Assistant. - Spanish-speaking ability is an advantage but not required. Desired Skills - Exceptional attention to detail and accuracy. - Strong organizational and time management skills. - Ability to work independently with minimal supervision. - Excellent problem-solving and critical-thinking abilities. - Comfortable managing multiple insurance requests, authorizations, and patient calls simultaneously. - Ability to thrive in a fast-paced, patient-centered healthcare environment. - Strong customer service and interpersonal communication skills. Basic Requirements - Must be proficient in speaking and writing English very clearly. - Must have relevant work experience. - Be able to submit an NBI clearance and/or Local Police Clearance background check before onboarding (mandatory). - Must be available for video meetings with your camera on (when needed). Technical Requirements - Device: Reliable laptop or desktop computer. - Internet: High-speed connection (minimum 25 Mbps). - Audio: Noise-canceling headset. - Video: Webcam for virtual meetings. - Workspace: Quiet, professional environment. Benefits - Dedicated HR & Contractor Support Team: Access to world-class support for questions, guidance, contract matters, and client communication. - Premium VPN Access (Optional): A secure VPN license can be provided upon request to enhance privacy and security for client-related tasks. - HIPAA & Cybersecurity Training + Certification (Provided): Access to our internal HIPAA compliance training, cybersecurity modules, and certification to help you confidently handle PHI for U.S. healthcare clients. - Top 1% VA Performance Training: Access to our proprietary training on communication, client management, productivity systems, and best practices to help you become a top-performing VA and increase long-term client retention. - Client-Approved U.S. Holidays: Contractors may take U.S. holidays off according to the client’s needs and schedule. - Client-Approved Paid or Unpaid Time Off: Time off may be granted by your client. Paid time off is optional and only if offered by the client. - Access to Tools & Resources: Templates, workflow guides, productivity tools, and client-specific SOP support to help you perform at your best. - Optional Performance-Based Incentives: Some clients may offer bonuses, incentives, or increased hours based on your performance.
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