Virtual Prior Authorization Specialist (Bilingual English/Spanish)

We are seeking an experienced and detail-oriented Virtual Prior Authorization Specialist to support a busy healthcare practice. This role is responsible for managing prior authorizations, insurance verification, referral coordination, and communication with insurance carriers to ensure patients receive timely access to care.

Ideal Candidate

• Understands the authorization process from start to finish.
• Is proactive with insurance follow-up and case management.
• Can effectively communicate with patients, providers, and insurance carriers.
• Thrives in a fast-paced environment while maintaining accuracy.
• Is reliable, accountable, and highly organized.

Key Responsibilities

• Submit and track prior authorizations for procedures, medications, imaging, and specialty services.
• Verify insurance eligibility, benefits, and authorization requirements.
• Follow up with insurance carriers regarding pending authorizations and approvals.
• Process and coordinate incoming and outgoing referrals.
• Communicate authorization updates and insurance information to patients when appropriate.
• Maintain accurate documentation and records within the EMR system.
• Collaborate with providers, clinical staff, and insurance representatives to support patient care.

Requirements

Qualifications

• Bilingual English/Spanish (Required).
• Minimum 2 years of Prior Authorization experience.
• Strong knowledge of insurance verification and authorization workflows.
• Experience working with Commercial Insurance, Medicare, and Managed Care plans.
• Excellent communication, customer service, and problem-solving skills.
• Strong organizational skills and attention to detail.
• Ability to work independently in a remote environment.

Preferred Qualifications

• Experience with Epic and/or Acumen EMR.
• Referral coordination experience.
• Denials and appeals experience.
• Specialty practice experience.
• Medical terminology knowledge.
• Experience in high-volume healthcare environments.

Benefits

Please note that this is a full-time contractor position (40 hours per week) with a pay rate of $6 - $7 per hour depending on skillset and experience. The schedule is Monday through Friday, from 9 AM to 5 PM US Time.