Provider Credentialing & Back-Office Insurance Specialist

Go Lean HealthBehavioral health

Source API remote eligibility restrictions: Philippines, 11:00 AM to 7:00 PM US Central TimePart-Time

Salary5 - 6 USD per hour

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Job Details

Languages: Professional verbal and written English communication; English and Spanish bilingual proficiency preferred.
Required Skills: EHRHIPAA

Have previous healthcare experience with substantial responsibility for insurance verification and prior authorizations.
Have experience working with US commercial insurance plans, Medicaid, or both.
Have experience contacting insurance companies and using payer portals.
Understand healthcare eligibility and authorization workflows.
Have experience using an EHR or practice-management system.
Demonstrate strong administrative documentation and data-entry skills.
Maintain high attention to detail and accuracy.
Have strong follow-up, organization, and task-management skills.
Communicate professionally in spoken and written English.
Work independently and manage multiple pending cases.
Understand HIPAA and patient confidentiality requirements.
Maintain reliable attendance and punctuality.

Verify patient eligibility and benefits with commercial insurance plans and Medicaid, and document results in AdvancedMD and related clinic systems.
Initiate and process prior authorization requests, contact insurance representatives, and track requests through resolution.
Review patient information and documentation for potential eligibility for nonprofit financial assistance or reduced-cost programs.
Follow up with patients to obtain missing forms, signatures, insurance details, and other enrollment requirements.
Set up patient profiles and portals, complete intake and enrollment records, and coordinate with the front-desk VMA before scheduling.
Organize provider credentialing documents, payer correspondence, application statuses, and renewal information; follow up on pending items.
Update patient records and prepare charts, resolving or escalating incomplete or inconsistent information before appointments.
Review outstanding cases, prioritize next actions, and document outreach, completed work, pending items, and resolution.
Document and update procedures for insurance verification, prior authorization, financial eligibility, and enrollment follow-up.

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