Prior Authorization Specialist

Winning Assistants LLC

Prior Authorization Specialist responsible for processing prior authorizations and verifying insurance coverage. Collaborating with healthcare providers and ensuring compliance with HIPAA regulations.

Posted 7/1/2026full-timeRemote • 🇵🇭 PhilippinesJunior💰 $5 - $6 per hourWebsite

About the role

Key responsibilities & impact

Process and submit prior authorization requests to insurance companies.
Verify patient insurance eligibility, benefits, and coverage.
Follow up with insurance carriers regarding authorization status.
Communicate professionally with providers, clinic staff, patients, and insurance representatives via phone and email.
Maintain accurate documentation of authorization requests, approvals, denials, and outcomes.
Update patient records and EMR/EHR systems with authorization information.
Investigate and resolve authorization issues, denials, or delays.
Monitor authorization expiration dates and submit renewal requests as needed.
Prioritize and manage multiple authorization cases while meeting deadlines.
Ensure compliance with HIPAA regulations and maintain patient confidentiality.

Requirements

What you’ll need

At least 1 year of experience in medical prior authorizations, medical billing, insurance verification, or a related healthcare administrative role.
Experience working with EMR/EHR systems.
Hands-on experience using insurance portals such as TRICARE, UnitedHealthcare (UHC), Availity, and similar payer portals for eligibility verification, authorization requests, and claim status inquiries.
Excellent verbal and written English communication skills.
Strong organizational skills with exceptional attention to detail.
Proficient in data entry and Microsoft Office/Google Workspace.
Ability to work independently in a fast-paced remote environment.
Understanding of HIPAA regulations and patient confidentiality requirements.

Benefits

Comp & perks

Dedicated HR & Contractor Support Team: Access to world-class support for questions, guidance, contract matters, and client communication.
Premium VPN Access (Optional): A secure VPN license can be provided upon request to enhance privacy and security for client-related tasks.
HIPAA & Cybersecurity Training + Certification (Provided): Access to our internal HIPAA compliance training, cybersecurity modules, and certification to help you confidently handle PHI for U.S. healthcare clients.
Top 1% VA Performance Training: Access to our proprietary training on communication, client management, productivity systems, and best practices to help you become a top-performing VA and increase long-term client retention.
Client-Approved U.S. Holidays: Contractors may take U.S. holidays off according to the client’s needs and schedule.
Client-Approved Paid or Unpaid Time Off: Time off may be granted by your client. Paid time off is optional and only if offered by the client.
Access to Tools & Resources: Templates, workflow guides, productivity tools, and client-specific SOP support to help you perform at your best.
Optional Performance-Based Incentives: Some clients may offer bonuses, incentives, or increased hours based on your performance.

ATS Keywords

✓ Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools

Prior Authorization ProcessingInsurance Eligibility VerificationMedical BillingDocumentation ManagementAuthorization Issue Resolution

Soft Skills

Excellent Communication SkillsStrong Organizational SkillsAttention to DetailAbility to Work Independently