Job Overview:

As a Health Insurance Specialist, you play a vital role in ensuring patients get the care they need without delay. You will bridge the gap between healthcare providers, insurers, and patients—turning complex payer requirements into seamless care access through efficient processing, sharp attention to detail, and top-tier service. 

Schedule: Remote, Full Time | Mon-Thurs from 8am to 5:30pm and Friday from 8:30am to 12:30pm EDT, with a 30 minute unpaid lunch break.

Responsibilities:

• Review, submit, and track prior authorization requests and Value-Based Care referrals to eliminate treatment delays.
• Apply in-depth knowledge of insurance guidelines, billing procedures, and healthcare regulations to ensure full compliance.
• Act as the primary point of contact between patients, healthcare providers, and insurance companies to provide clear, timely updates.
• Proactively follow up on pending requests and coordinate appeals when authorizations are denied to secure approvals.
• Partner with internal teams—including Care Connection, billing, and clinical staff—to check benefits and optimize revenue cycle efficiency.
• Answer patient calls, review voicemails, and address inquiries from both internal and external stakeholders promptly and empathetically.
• Maintain precise documentation while safeguarding patient data in full accordance with HIPAA and organizational values.

Requirements:

• High School Diploma required (Bachelor’s preferred) with 3–5+ years of prior authorization experience handling Medicare, Medicaid, Commercial, and third-party payers.
• Proficient in Microsoft Office (Excel, Word, PowerPoint, Visio) with a dual-monitor setup and USB-C adapter compatibility; skilled in navigating regulatory databases (CMS, HRSA, AHCA).
• Deep understanding of insurance rules, benefit verification, authorization workflows, and strict compliance with HIPAA and client-required training standards.
• Strong analytical and decision-making skills to research complex payer guidelines, resolve issues, and independently drive tasks to completion.
• Sharp attention to detail in data entry and record-keeping with proven time-management skills to balance shifting priorities and meet tight deadlines.
• Excellent written and verbal communication skills to effectively bridge patients, providers, payers, and internal teams.
• Self-motivated team player comfortable working in a diverse, fast-paced environment with minimal supervision and a commitment to quality care.

Independent Contractor Perks:

• Health Insurance
• Immediate hiring
• Permanent work from home

Note:

• Please click the "Apply" button to complete your application, including the assessment questions, technical check, and voice recording. Your hourly pay rate will be established based on your performance in the application process; submissions with all requirements fulfilled will receive priority review.

Important Disclaimer:

• BruntWork never charges fees for applying or any part of the hiring process—it is 100% free. If you are ever asked for payment, please stop and report it immediately to our official email us through the ‘Contact Us’ form on our official BruntWork website.