Summary
The Healthcare Insurance Coordinator plays a key role in managing insurance verification and authorization processes. This position requires a strong understanding of payer-specific requirements and healthcare documentation workflows. You’ll be responsible for ensuring coverage eligibility, securing treatment approvals, and maintaining compliance with all payer and regulatory standards. It’s a great fit for someone with deep experience in U.S. healthcare insurance who thrives in a detail-heavy, process-driven environment.
Responsibilities and Requirements
Responsibilities:
1. Verification of Benefits (VOB):
Contact insurance providers to verify patient eligibility, coverage, and policy details
Accurately document payer responses in internal systems
Flag missing or unclear information for internal review
Follow payer-specific guidelines (e.g., Medicaid vs. commercial insurance)
2. Initial Authorization Support:
Review patient intake documents and clinical recommendations
Complete payer-specific authorization request forms
Compile supporting documentation (e.g., treatment plans, credentials)
Track confirmation statuses and manage timely follow-ups
3. Treatment Re-Authorization:
Review and summarize clinical documentation and ongoing treatment plans in compliance with payer guidelines
Extract and format key data such as CPT codes, progress notes, and session logs
Collaborate with clinical staff for clarification and missing details
Track submission timelines to avoid lapses in treatment approvals
Requirements:
4+ years of experience in U.S. healthcare insurance coordination or revenue cycle management
In-depth knowledge of VOB, prior authorizations, and treatment re-authorizations
Familiarity with Medicaid and commercial insurance guidelines and workflows
Proficient in navigating payer portals or healthcare systems
Exceptional attention to detail and organizational skills
Strong English communication skills (written and verbal)
Ability to handle sensitive patient data with professionalism and confidentiality
Reliable internet connection and ability to work 45 hours per week consistently (PST hours)