Bilingual Back-Office Insurance & Prior AuthorizationRemote | Behavioral Health | 30 hours/week | $7/HourWorking Hours: 11:00 AM to 7:00 PM US Central TimeRole OverviewWe are seeking an experienced Bilingual Back-Office Insurance & Prior Authorization Virtual Medical Assistant to support a nonprofit behavioral health organization in the United States.This position will focus primarily on the administrative and insurance-related work required to move patients successfully through enrollment and prepare them for care.The clinic serves patients using multiple payer arrangements, including commercial insurance, Medicaid, self-pay, and nonprofit programs that may reduce or eliminate the patient's cost of care. Because each patient may require a different process, the successful candidate must be highly organized and capable of determining what documentation, eligibility verification, authorization, or follow-up is needed for each case.You will also help address existing administrative backlogs and build reliable back-office processes that the organization can continue using as it grows.Key ResponsibilitiesInsurance Verification & Benefits- Verify patient eligibility and applicable 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 a patient from progressing through enrollment.Prior Authorizations- Initiate and process prior authorization requests according to payer and clinic requirements.- Communicate with insurance representatives and use payer portals to obtain requirements, authorization status, and supporting information.- Track pending authorization requests and follow them through approval, denial,



or other appropriate resolution.Patient Care Coordination, Intake & Enrollment- Support patient intake by setting up patient profiles and portals, collecting required forms, and ensuring demographic and insurance information is complete and accurately documented.- Review intake documentation for missing or incomplete information and conduct outbound follow-up with patients to obtain required forms, signatures, insurance details, or other enrollment requirements.- Track each patient through the intake and enrollment process, coordinate with the front-desk VMA, and confirm that all required administrative steps are completed before the patient proceeds to scheduling.Financial Eligibility & Patient Follow-Up- Review patient information and required documentation to determine potential eligibility for nonprofit financial assistance or reduced-cost programs.- Conduct outbound follow-up with patients regarding missing forms, insurance information, signatures, or other incomplete enrollment or eligibility requirements.- Maintain accurate documentation of eligibility status and pending requirements, and coordinate with the front-desk VMA once the patient is ready to proceed toward scheduling.Provider Credentialing Support- Assist with provider insurance credentialing and payer enrollment as the clinic expands the scope of the position.- Organize required credentialing documents, payer correspondence, application statuses,



and renewal information.- Follow up on pending credentialing items and communicate outstanding requirements to the appropriate clinic team member.Required Qualifications- Previous healthcare experience with substantial responsibility for insurance verification and prior authorizations.- Experience working 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.- Ability to work independently and manage multiple pending cases.- Strong understanding of HIPAA and patient confidentiality requirements.- Reliable attendance and punctuality.Preferred Qualifications- Behavioral health or mental health administrative experience.- Experience with AdvancedMD.- Experience evaluating patient financial eligibility.- Experience supporting Medicaid populations.- English and Spanish bilingual proficiency.Systems & ToolsThe clinic uses or expects the VMA to work with:- AdvancedMD- Microsoft Teams- Phone services- Insurance payer portals- Patient intake portals and online forms- VPN and secure remote-access systems- Time DoctorRemote Work RequirementsCandidates must maintain:- Private and secure home workspace- Reliable computer capable of supporting healthcare applications and multiple browser-based systems- Stable primary internet connection, reliable backup internet- Verified backup power source- Professional headset- Secondary monitor- Quiet working environment appropriate for patient and insurance calls#J-18808-Ljbffr

📌 Bilingual Back-Office Insurance & Prior Authorization (Arequipa)
🏢 Go Lean Health
📍 Arequipa