Insurance Verification and Prior Authorization Specialist - Virtual Assistant

Job Title: Insurance Verification and Prior Authorization Specialist - Virtual Assistant
Location: Remote
Interviewer: Brandi

Virtual Rockstar is an industry-leading company based in Arizona that specializes in offloading administrative tasks from healthcare clinics to streamline operations. We hire specifically in the Philippines, aiming to build and strengthen families in the region through meaningful employment opportunities. We are committed to hiring individuals who not only meet our job requirements but also align with our core values and long-term vision.

Virtual Rockstar is seeking a full-time Insurance Verification and Prior Authorization Specialist to join our client’s growing team. This key role involves verifying patient insurance coverage, obtaining prior authorizations for procedures, processing claims, and addressing patient inquiries related to insurance and billing. You will work closely with the clinical and administrative staff to ensure that patients receive the care they need without unnecessary delays or complications.

About our client:

Our client is a leading physical therapy practice in Texas, dedicated to serving the local community by helping individuals restore function, achieve physical goals, and unlock their full potential through personalized, compassionate care. With a commitment to promoting health and treating every patient with respect, they provide innovative, patient-centered care in every interaction. They aim to foster a sense of family and belonging while empowering patients to achieve optimal health and wellness.

Mission Statement:
We are committed to serving our community by helping individuals restore function, achieve their physical goals, and unlock their full potential through compassionate care.

Vision Statement:
To be the leading provider of innovative, patient-centered care, empowering our community to achieve optimal health and wellness.

Core Values:

Community-Centered Care: We are dedicated to improving the health and well-being of our local community.
Empowerment: We help patients unlock their full potential, guiding them to surpass physical goals they never thought possible.
Restoration and Functionality: We prioritize restoring function and promoting long-term health for every patient.
Respect and Compassion: Every patient is treated with the utmost respect, dignity, and compassion.
Commitment to Education: We provide education to help both patients and the broader community maintain their health and wellness.

Responsibilities:

Patient and Insurance Communication:
Handle patient inquiries via phone and email.
Explain insurance benefits to patients and clarify coverage details.
Liaise with insurance providers to ensure accurate insurance verification and obtain pre-authorizations for procedures.
Assist patients with insurance-related queries.
Maintain patient privacy and confidentiality.

Insurance Verification & Claims Management:
Verify patient insurance coverage and update patient records accordingly.
Track and manage insurance claims status.
Process and submit claims to insurance companies and follow up on unpaid claims.
Resolve billing discrepancies and review/appeal denied claims.
Ensure compliance with coding and billing regulations.
Post payments to patient accounts and generate billing reports for management.

Scheduling & Coordination:
Coordinate with medical staff to manage daily schedules and appointment rescheduling.
Manage therapists' schedules and ensure timely patient appointments.
Assist with generating and sending invoices.
Maintain and update electronic medical records, including insurance information.
Manage a waitlist for appointments and assist with filing and equipment maintenance.

Administrative Support:
Assist with filing, organizing events, and handling online purchases.
Data entry and generate basic reports as needed.
Prepare documents and manage email correspondence.

Qualifications:

Experience with Prompt EMR, Availity, and other insurance portals is preferred.
Strong understanding of insurance verification, prior authorizations, and claim management processes.
Excellent communication skills and ability to explain insurance benefits to patients clearly.
Ability to handle patient inquiries and ensure a positive experience.
Experience in scheduling, maintaining medical records, and managing patient appointments.
High attention to detail and organizational skills.
Knowledge of insurance claims processes, including follow-ups and appeals.
Proficiency in data entry, generating reports, and using medical software.
Ability to work independently in a virtual environment while maintaining team collaboration.

Benefits:

Competitive salary commensurate with experience.
Opportunities for professional development and growth.
Work in a dynamic and supportive team environment.
Make a meaningful impact by helping to build and strengthen families in the Philippines.

How to Apply:

To apply for this position, please send us a copy of your updated resume and a Loom video (not Google Drive) addressed to The Rockstar Team. In the video, explain your relevant work history and give a brief introduction about yourself. Please provide detailed insights into your previous experience as a virtual assistant. If you have prior experience supporting a physical therapy team, we'd appreciate hearing about it. We're seeking candidates with outstanding communication and customer service skills, so please emphasize these qualities in your video introduction. Lastly, share your creative ideas on how you can contribute to the growth and success of our company. We're eager to see your application!