Bilingual Prior Authorization & Insurance Verification Specialist

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.