Bilingual Back-Office Insurance & Prior Authorization

Remote | Behavioral Health | 30 hours/week | $7/Hour

Working Hours: 11:00 AM to 7:00 PM US Central Time

Role Overview

We are seeking an experienced Bilingual Back-Office Insurance & Prior Authorization Virtual Medical Assistant to support a nonprofit behavioral health organization in the United States.

This position will focus primarily on the administrative and insurance-related work required to move patients successfully through enrollment and prepare them for care.

The clinic serves patients using multiple payer arrangements, including commercial insurance, Medicaid, self-pay, and nonprofit programs that may reduce or eliminate the patient's cost of care. Because each patient may require a different process, the successful candidate must be highly organized and capable of determining what documentation, eligibility verification, authorization, or follow-up is needed for each case.

You will also help address existing administrative backlogs and build reliable back-office processes that the organization can continue using as it grows.

Key Responsibilities

Insurance Verification & Benefits

- Verify patient eligibility and applicable benefits with commercial insurance plans and Medicaid.

- Review payer information and document verification results accurately in AdvancedMD and related clinic systems.

- Identify insurance requirements, coverage issues, or missing information that could prevent a patient from progressing through enrollment.

Prior Authorizations

- Initiate and process prior authorization requests according to payer and clinic requirements.

- Communicate with insurance representatives and use payer portals to obtain requirements, authorization status, and supporting information.

- Track pending authorization requests and follow them through approval, denial, or other appropriate resolution.





Patient Care Coordination, Intake & Enrollment

- Support patient intake by setting up patient profiles and portals, collecting required forms, and ensuring demographic and insurance information is complete and accurately documented.

- Review intake documentation for missing or incomplete information and conduct outbound follow-up with patients to obtain required forms, signatures, insurance details, or other enrollment requirements.

- Track each patient through the intake and enrollment process, coordinate with the front-desk VMA, and confirm that all required administrative steps are completed before the patient proceeds to scheduling.

Financial Eligibility & Patient Follow-Up

- Review patient information and required documentation to determine potential eligibility for nonprofit financial assistance or reduced-cost programs.

- Conduct outbound follow-up with patients regarding missing forms, insurance information, signatures, or other incomplete enrollment or eligibility requirements.

- Maintain accurate documentation of eligibility status and pending requirements, and coordinate with the front-desk VMA once the patient is ready to proceed toward scheduling.

Provider Credentialing Support

- Assist with provider insurance credentialing and payer enrollment as the clinic expands the scope of the position.

- Organize required credentialing documents, payer correspondence, application statuses, and renewal information.





- Follow up on pending credentialing items and communicate outstanding requirements to the appropriate clinic team member.

Required Qualifications

- Previous healthcare experience with substantial responsibility for insurance verification and prior authorizations.

- Experience working with US commercial insurance plans, Medicaid, or both.

- Experience contacting insurance companies and using payer portals.

- Strong understanding of healthcare eligibility and authorization workflows.

- Experience using an EHR or practice-management system.

- Strong administrative documentation and data-entry skills.

- High attention to detail and accuracy. Strong follow-up, organization, and task-management skills.

- Ability to work independently and manage multiple pending cases.

- Strong understanding of HIPAA and patient confidentiality requirements.

- Reliable attendance and punctuality.

Preferred Qualifications

- Behavioral health or mental health administrative experience.

- Experience with AdvancedMD.

- Experience evaluating patient financial eligibility.

- Experience supporting Medicaid populations.

- English and Spanish bilingual proficiency.

Systems & Tools

The clinic uses or expects the VMA to work with:

- AdvancedMD

- Microsoft Teams

- Phone services

- Insurance payer portals

- Patient intake portals and online forms

- VPN and secure remote-access systems

- Time Doctor

Remote Work Requirements

Candidates must maintain:

- Private and secure home workspace

- Reliable computer capable of supporting healthcare applications and multiple browser-based systems

- Stable primary internet connection, reliable backup internet

- Verified backup power source

- Professional headset

- Secondary monitor

- Quiet working environment appropriate for patient and insurance calls

📌 Bilingual Back-Office Insurance & Prior Authorization (Cali)
🏢 Go Lean Health
📍 Cali