[Hiring] Spanish-English Medical Admin - Prior Auth & Insurance Verification @Winning Assistants

Role Description

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

• 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.

Qualifications

• 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.