Insurance Verification Specialist (Prior Authorizations)

📍 Job Type: Full-Time (40 hours/week)
💲 Salary: $5.00–$6.00 USD per hour (depending on experience)
🗓 Schedule: Monday to Friday
🕘 Working Hours: 9:00 AM – 6:00 PM Pacific Time (PT)

About the Role

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.

Requirements

Required 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.

Ideal Personality

We're looking for someone who is:

• Detail-oriented and highly organized.
• Reliable, dependable, and accountable.
• Proactive with a strong sense of ownership.
• Professional, courteous, and patient-focused.
• Calm under pressure and able to prioritize effectively.
• Friendly, empathetic, and confident when speaking with patients.
• Committed to accuracy, efficiency, and delivering high-quality work.

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.

These are optional resources and client-approved allowances available to you as an independent contractor. Any resources, training, or allowances listed are optional contractor perks and not employee benefits.