Bilingual Medical Administrative Specialist – Prior Authorization & Insurance Verification

Client Overview and Job Summary

Our client is a healthcare practice focused on providing patient-centered medical services and ensuring patients receive coordinated, timely care. The practice works closely with patients, healthcare providers, insurance companies, and specialist offices to keep the administrative side of patient care moving efficiently.

We are looking for an experienced Bilingual Medical Administrative Specialist who is comfortable taking ownership of prior authorizations, insurance verification, medical clearance follow-ups, scheduling support, and patient communication.

You'll work closely with the Practice Manager, scheduling team, patients, provider offices, and other members of the practice. The ideal candidate doesn't need constant supervision—you know how to follow up, stay organized, identify what needs attention, and take initiative.

Key Responsibilities

Prior Authorization Management & Follow-Up

• Process and manage prior authorization requests from start to finish.
• Track pending authorizations and proactively follow up on outstanding cases.
• Maintain accurate status updates and ensure cases continue moving forward.
• Notify the scheduling team as soon as cases have been cleared and are ready for scheduling.
• Identify delays or missing information and take appropriate follow-up action.

Insurance Verification

• Verify patient insurance eligibility, coverage, and benefits.
• Review and confirm insurance information before appointments and procedures.
• Handle insurance verification involving Medicare patients and Medicare-related requirements.
• Communicate with insurance companies when additional information or clarification is required.
• Document verification results accurately within the practice's workflow.

Cardiology Clearance Follow-Ups

• Contact cardiologist offices to request required medical clearances.
• Follow up consistently on outstanding clearance requests.
• Track the status of each clearance and maintain accurate documentation.
• Coordinate with internal team members once clearances are received.

Scheduling Support

• Assist the scheduling team by identifying patients and cases that are cleared and ready to schedule.
• Help coordinate appointments and communicate scheduling information.
• Work closely with authorization and clinical workflows to prevent unnecessary scheduling delays.

Patient Communication

• Communicate professionally with patients in both English and Spanish.
• Contact patients regarding appointments, scheduling, insurance, prior authorizations, medical clearances, and other administrative requirements.
• Provide clear and courteous explanations while maintaining a positive patient experience.

Virtual Reception & Front-Desk Support

• Provide virtual front-desk and receptionist support when needed.
• Assist with patient-facing administrative responsibilities.
• Help route questions and administrative needs to the appropriate team member.

General Administrative Support

• Support the Practice Manager and other team members with day-to-day administrative needs.
• Step into different responsibilities as priorities and workflows change.
• Learn and follow the practice's established processes while looking for opportunities to keep work organized and moving efficiently.

Requirements

• Previous healthcare industry experience.
• Hands-on experience with prior authorizations.
• Experience performing insurance eligibility and benefits verification.
• Familiarity with Medicare processes and requirements.
• Professional fluency in English and Spanish, both written and verbal.
• Strong organizational and follow-up skills with excellent attention to detail.
• Excellent written and verbal communication skills, particularly when communicating with patients, insurance representatives, and provider offices.
• Ability to manage multiple open cases and priorities without losing track of important follow-ups.
• Proactive and self-sufficient working style with the ability to perform effectively with minimal micromanagement.
• Flexibility and adaptability—you should be comfortable wearing multiple hats and supporting different team members as priorities change.
• Ability to learn new processes and workflows quickly.
• Comfortable working independently in a remote environment.

Highly Preferred

• Previous experience using eClinicalWorks (eCW).
• Experience with a similar Electronic Health Record (EHR) or Electronic Medical Record (EMR) platform will also be considered.
• Candidates without direct eClinicalWorks experience should be comfortable learning the platform quickly.
• Previous experience communicating directly with Spanish-speaking patients.
• Experience coordinating medical clearances or communicating with specialist/provider offices.

Basic Requirements

• Must speak and write English clearly and professionally.
• Must have relevant work experience.
• Must be able to provide an NBI Clearance and/or Local Police Clearance before onboarding (mandatory).
• Must be available to attend video meetings with camera on when required.

Technical Requirements

• Computer: Reliable laptop or desktop computer.
• Internet: Stable high-speed internet connection (minimum 25 Mbps).
• Audio: Noise-canceling headset.
• Video: Working webcam for virtual meetings.
• Workspace: Quiet and professional work environment.

Benefits

• 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.

These are optional resources and client-approved allowances available to you as an independent contractor. Any resources, training, or allowances listed are optional contractor perks and not employee benefits.