Healthcare Insurance Coordinator

19 hours ago

Calamba, Philippines OpsArmy Full time

Overview

Healthcare Insurance Coordinator (Full-Time)

Schedule: 45 hours/week | 9:00 AM - 5:00 PM PST

Location: Fully Remote

About The Role

We are seeking an experienced and detail-oriented Healthcare Insurance Coordinator to support our insurance verification and authorization processes. This role is ideal for someone with a strong background in U.S. healthcare insurance, who thrives in a structured, fast-paced, and compliance-driven environment.

Responsibilities
  1. Verification of Benefits (VOB)
    • Contact insurance providers to verify patient eligibility and coverage
    • Accurately document payer responses in internal systems
    • Flag missing or unclear information for internal review
    • Follow payer-specific guidelines (e.g., Medicaid vs. commercial insurance)
  2. Initial Authorization Support
    • Review patient intake documents and treatment recommendations
    • Complete payer-specific authorization request forms
    • Assemble and submit packets with supporting documents (e.g., treatment plans, credentials)
    • Use payer portals, fax, or email to submit authorizations
    • Track confirmation statuses and log any necessary follow-ups
  3. Treatment Re-Authorization
    • Review clinical documentation and ongoing treatment plans
    • Summarize clinical data in alignment with payer requirements
    • Ensure all documentation meets compliance standards (e.g., measurable goals)
    • Copy and format relevant data (e.g., CPT codes, session logs)
    • Coordinate with clinicians for clarification and missing details
    • Track submission timelines to avoid lapses in treatment approvals
Qualifications
  • 4+ years of experience in U.S. healthcare insurance coordination or revenue cycle management
  • Deep understanding of VOB, prior authorizations, and treatment re-authorizations
  • Familiarity with payer guidelines, including Medicaid and commercial plans
  • Experience working with insurance portals or healthcare systems
  • High attention to detail and ability to handle sensitive patient data securely
  • Excellent written and verbal communication skills in English
  • Reliable internet connection and ability to work consistently 45 hours per week
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