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Pre-Authorization & Referral Coordinator

MyVA Support

Role overview

Qualifications

  • 2+ years of experience in a U.S. medical office handling insurance verification and prior authorizations
  • Proven hands-on experience obtaining authorizations independently (not only assisting)
  • Strong knowledge of Medicare, Medicaid, and commercial plans (HMO, PPO, POS)
  • Working knowledge of ICD-10 and CPT codes

Responsibilities

  • Verify active insurance coverage and review detailed benefits
  • Determine patient financial responsibility (copays, deductibles, coinsurance, out-of-pocket maximums)
  • Obtain and manage prior authorizations for procedures, imaging, and specialty services
  • Submit and track authorization requests through payer portals (Availity, UHC, Aetna, Cigna, etc.)

Key facts

  • Remote from: Latin America
  • Full time
  • Mid-level (2-5 years)
  • Spanish, English

Hard skills

Prior Authorization Electronic Referrals E-MDs (EMR/EHR System) Medicare Medicaid Commercial Insurances ICD 503 CPT Coding Communicating With Patients Organizational Structure

Other skills

  • Verbal Communication Skills
  • Detail Oriented
  • Time Management

About the company

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MyVA Support

Staffing & Recruiting

We are just exactly what you need, Virtual assistant services that can fulfill any type of position within your company while saving you time and money.

Company details

Company typeStartup
IndustryStaffing & Recruiting
Company size11 - 50

Links

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Job description

This is a remote position.

Only LATAM-based candidates (bilingual in Spanish and English)

We are hiring an experienced Pre-Authorization & Referral Coordinator to support a fast-paced U.S.-based medical office.

This role is responsible for insurance verification, prior authorizations, and referral coordination while ensuring compliance with U.S. insurance guidelines. The ideal candidate has direct experience working within the U.S. healthcare system handling Medicare, Medicaid, and commercial insurance plans.

This is a full-time remote position supporting a medical practice located in the United States. The role is offered as an Independent Contractor opportunity.

Key Responsibilities
  • Verify active insurance coverage and review detailed benefits
  • Determine patient financial responsibility (copays, deductibles, coinsurance, out-of-pocket maximums)
  • Obtain and manage prior authorizations for procedures, imaging, and specialty services
  • Submit and track authorization requests through payer portals (Availity, UHC, Aetna, Cigna, etc.)
  • Review and attach required clinical documentation
  • Process and track internal and external referrals
  • Ensure compliance with HMO referral requirements
  • Enter and document authorization details in EMR/EHR systems
  • Follow up on pending authorizations and assist with resolving denials
  • Communicate insurance requirements and authorization status clearly to patients


Requirements

  • 2+ years of experience in a U.S. medical office handling insurance verification and prior authorizations
  • Proven hands-on experience obtaining authorizations independently (not only assisting)
  • Strong knowledge of Medicare, Medicaid, and commercial plans (HMO, PPO, POS)
  • Solid understanding of deductibles, copays, coinsurance, and out-of-pocket maximums
  • Working knowledge of ICD-10 and CPT codes
  • Experience using payer portals (Availity, UnitedHealthcare, Aetna, Cigna, etc.)
  • Experience working with EMR/EHR systems
  • High attention to detail and ability to manage high-volume workflows
  • Strong English communication skills (written and verbal)
  • Reliable high-speed internet connection (minimum 100 MB)
  • Own laptop or desktop and professional headset


Benefits

  • 100% Remote position
  • Full-time schedule (Monday–Friday)
  • Weekends off
  • Performance-based bonuses



Salary: 1,000 USD/month

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MR

Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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