Job Title: Bilingual Prior Authorization & Insurance Verification Specialist
Position Type: Full-Time
Work Hours: 9:00 AM – 6:00 PM Pacific Time
Work Days: Monday to Friday
Salary: $6 - $7 hourly
Workplace: Remote
Preferred Candidate Location: LATAM
About the Client & Role
Our client is a busy dermatology practice serving over 100 patients per week. The practice is looking for a reliable and detail-oriented Bilingual Prior Authorization & Insurance Verification Specialist to support insurance eligibility verification, prior authorizations, insurance-related phone calls, documentation, and overflow patient call support.
This is not solely a backend insurance role. The VA must be confident in communicating by phone with insurance representatives and patients while accurately documenting information, tracking unresolved items, and following through on authorization requirements.
The ideal candidate has strong experience with U.S. healthcare insurance verification, prior authorization management, phone support, documentation, and task follow-up. Spanish-speaking ability is required.
Scope of Work / Responsibilities
Insurance Eligibility & Benefits Verification
Verify patient insurance eligibility, active coverage, and benefits accurately.
Confirm effective dates, plan type, network status, copays, deductibles, coinsurance, out-of-pocket information, referral requirements, and authorization requirements.
Document all eligibility and benefit information clearly in EZ Derm and/or the practice’s designated workflow.
Ensure insurance details are accessible to the appropriate practice staff.
Insurance Calls & Documentation
Communicate directly with insurance companies regarding eligibility, benefits, authorization requirements, and pending requests.
Document every insurance call completely, including representative name, call reference number, date and time, phone number called, information obtained, and required next action.
Maintain accurate records of insurance calls, eligibility results, authorization updates, pending items, and required follow-ups.
Prior Authorization Management
Manage prior authorizations from submission through final resolution.
Submit prior authorization requests with complete supporting documentation.
Track status updates, additional information requests, approvals, denials, authorization numbers, approved codes, approved units, and authorization date ranges.
Manage submission and tracking of prior authorizations for biologic medications.
Communicate authorization outcomes and next steps to the appropriate practice staff.
Task Follow-Up & Escalation
Create and maintain follow-up tasks for any insurance or authorization item that cannot be completed immediately.
Ensure each pending item has a clear next action and appropriate follow-up date.
Track outstanding items until they are completed, resolved, or escalated.
Escalate clinical, financial, missing information, denial, delay, or decision-making concerns to the Office Manager, Front Office Team, Medical Assistant, or Provider as appropriate.
Phone Support & Patient Communication
Handle insurance-related phone calls as the primary focus of the role.
Provide overflow patient call support as operational needs allow.
Prioritize insurance and authorization responsibilities so general patient call volume does not delay timely follow-up.
Daily Reporting & Administrative Boundaries
Provide a daily End of Day report summarizing completed work and outstanding items.
Include eligibility verifications completed, authorizations submitted, pending authorizations followed up on, approvals and denials received, unresolved items, and matters requiring staff action.
Relay approved administrative information only and maintain appropriate clinical and financial boundaries.
Maintain patient confidentiality and comply with HIPAA and practice policies at all times.
Tools You’ll Use
EZ Derm
3CX phone system
Insurance portals and payer systems
Practice task and documentation…