This is a remote position.
Rockstar is seeking a detail-oriented and experienced Insurance Verification & Authorization Specialist to support U.S.-based healthcare practices on a full-time remote basis. This is a specialized back-office role built for professionals who thrive on accuracy, process, and follow-through, and who understand that getting insurance right the first time directly protects patients and practices alike.
In this role, you will be the primary owner of insurance verification and prior authorization workflows, working closely with front office schedulers, billing teams, and clinical staff to ensure every patient is properly verified and authorized before their appointment. You will communicate regularly with insurance payers, maintain accurate records in the client's EMR system, and help prevent billing delays, denials, and revenue loss.
KEY RESPONSIBILITIES
Insurance Verification & Eligibility
- Verify patient insurance eligibility and benefits prior to all scheduled appointments
- Confirm coverage details including co-pays, co-insurance, deductibles, out-of-pocket maximums, and coverage limitations
- Identify and document patient financial responsibility at least 24 hours before patient arrival
- Update patient files and EMR records with accurate, complete insurance and eligibility information
- Communicate verification results clearly to clinical and administrative staff
- Handle a broad range of insurance types including commercial plans, Medicare, Medicaid, workers' compensation, and auto claims
Prior Authorization & Authorization Management
- Obtain prior authorizations for procedures, therapy visits, and services as required by insurance plans
- Submit authorization requests via phone, payer portals, and electronic systems in a timely manner
- Track authorization approvals, denials, pending requests, and expiration dates in an organized manner
- Follow up proactively on pending authorizations to prevent gaps in care or appointment cancellations
- Renew authorizations as ongoing treatment requires and maintain complete records of all authorization activity
- Escalate unresolved authorization issues to the appropriate internal team member promptly
Payer Communication & Issue Resolution
- Liaise directly with insurance companies via phone and payer portals to clarify coverage, resolve discrepancies, and obtain benefit details
- Assist patients and clinical staff with insurance-related questions and benefit explanations
- Identify and help prevent claim rejections caused by inaccurate or incomplete insurance information
- Assist billing teams with insurance-related documentation, claim support, and records retrieval as needed
Documentation & Administrative Support
- Maintain accurate, organized electronic patient records and insurance documentation in the EMR
- Type, upload, and manage patient forms and insurance-related documents
- Process and organize incoming faxes, referrals, and payer correspondence
- Generate basic reports and tracking logs to support verification workflow oversight
- Maintain strict HIPAA compliance and patient confidentiality at all times
- Participate in team meetings, training sessions, and check-ins as required by the client
Requirements
Required
- 2+ years of experience in medical insurance verification, prior authorization, or a related healthcare administrative role
- Strong working knowledge of insurance terminology, benefit structures, eligibility processes, and payer requirements
- Proven ability to interpret and communicate benefit details accurately to both clinical staff and patients
- Experience working directly with insurance companies via phone and online payer portals
- High attention to detail and a track record of accuracy in data entry and documentation
- Excellent written and verbal English communication skills, clear phone communication is essential
- Strong organizational skills with the ability to manage high volumes of verifications and authorizations simultaneously
- Ability to work independently, meet daily targets, and maintain consistent communication with client teams
- Reliable home office setup with a stable internet connection suitable for HIPAA-compliant remote work
Preferred
- Experience supporting U.S.-based outpatient healthcare clinics: physical therapy, occupational therapy, speech therapy, or similar specialties
- Familiarity with common healthcare EMR platforms (e.g., Prompt, WebPT, Raintree, or similar)
- Experience handling Medicare, workers' compensation, and auto insurance claims
- Background in multi-location or high-volume clinic environments
- Comfort with Google Workspace, Slack, or other cloud-based communication and productivity tools
WHAT WE LOOK FOR
- Precision: you catch errors before they become denials, and you take pride in doing it right the first time
- Proactive follow-through: you track open items, follow up without being reminded, and close the loop
- Clear communication: you can explain a complex benefit structure to a patient or a clinic staff member with equal clarity
- Reliability: your client team counts on your daily output, you show up, you deliver, and you flag issues early
- Adaptability: insurance workflows vary by payer and by practice, you learn quickly and adjust without frustration
Benefits
Originally posted on Himalayas
