Insurance Verification Specialist – Prior Authorizations

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Winning Assistants LLC

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51 - 200 employees

At Winning Assistants, we help doctors, healthcare professionals, and business owners save time, cut costs, and scale their operations with highly skilled, HIPAA-compliant virtual assistants. Our VAs handle tasks like admin support, medical office management, marketing, and customer service, allowing you to focus on growth.

📋 Description

• 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.

🎯 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.