Bilingual Medical Admin Specialist – Prior Auth, Insurance Verification

This is a fully remote position, open to applicants in Brazil, +5 more states.

📋 Description

• Manage and process prior authorization requests from initiation to completion

• Monitor pending authorizations and proactively pursue follow-ups on outstanding cases

• Ensure accurate updates on authorization status and facilitate the progress of cases

• Inform the scheduling team when cases are approved and ready for scheduling

• Identify delays or missing information and take necessary follow-up actions

• Verify patient insurance eligibility, coverage, and benefits

• Review and validate insurance details prior to appointments and procedures

• Handle insurance verification for Medicare patients and associated requirements

• Communicate with insurance companies when further information or clarification is needed

• Accurately document verification results within the practice's workflow

• Reach out to cardiologist offices to request necessary medical clearances

• Follow up on pending clearance requests and monitor clearance status

• Collaborate with internal team members once clearances are obtained

• Aid the scheduling team by identifying cleared patients and cases ready for scheduling

• Assist in coordinating appointments and conveying scheduling information

• Professionally communicate with patients in both English and Spanish

• Contact patients regarding appointments, scheduling, insurance, prior authorizations, medical clearances, and other administrative needs

• Provide virtual front-desk and receptionist support as required

• Assist with patient-facing administrative tasks and direct inquiries appropriately

• Support the Practice Manager and team members with daily administrative tasks

• Adjust to shifting priorities, learn established processes, and maintain organized workflows

⛳️ Requirements

• Prior experience in the healthcare industry

• Practical experience with prior authorizations

• Experience in performing insurance eligibility and benefits verification

• Familiarity with Medicare processes and requirements

• Professional fluency in both English and Spanish, both written and verbal

• Strong organizational and follow-up skills with exceptional attention to detail

• Excellent written and verbal communication abilities

• Capability to manage multiple open cases and competing priorities

• Proactive, self-sufficient working style with minimal supervision needed

• Flexibility and adaptability to support evolving priorities

• Quick learner of new processes and workflows

• Ability to work independently in a remote setting

• Previous experience with eClinicalWorks is highly preferred

• Experience with an EHR or EMR platform is considered

• Direct communication experience with Spanish-speaking patients is highly preferred

• Experience in coordinating medical clearances or communicating with specialist/provider offices is highly preferred

• Ability to articulate and write in English clearly and professionally

• Relevant work experience is essential

• Must provide an NBI Clearance and/or Local Police Clearance prior to onboarding

• Must participate in video meetings with the camera on when required

• Reliable laptop or desktop computer is necessary

• Stable high-speed internet connection of at least 25 Mbps is required

• Noise-canceling headset is essential

• Operational webcam is necessary

• Quiet and professional work environment is a must

🏝️ Benefits

• Dedicated HR & Contractor Support Team

• Premium VPN Access (Optional)

• HIPAA & Cybersecurity Training + Certification (Provided)

• Top 1% VA Performance Training

• Client-Approved U.S. Holidays

• Client-Approved Paid or Unpaid Time Off

• Access to Tools & Resources

• Optional Performance-Based Incentives

• Optional contractor perks and client-approved allowances available to independent contractors