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Prior Authorization Representative (Insurance Coordinator) (On Site) -Colombia

StatLinx LLC specializes in providing telephone answering and screening services to physicians and medical facilities across the United States. Our mission is to support healthcare providers by ensuring seamless communication and efficient operations. As we continue to grow, we seek dedicated professionals to join our team in Bogotá, Colombia.

Position Summary:

The Prior Authorization Representative will be responsible for reviewing and processing prior authorization requests for medications, procedures, and treatments. This role involves coordinating with healthcare providers, insurance companies, and patients to ensure timely approvals, minimize delays, and support continuity of care. The ideal candidate is detail-oriented, efficient under pressure, and provides excellent customer service to healthcare providers.

You must live within Bogota and Medellin, Colombia to apply.

We currently have full-time opportunities available. ALL SHIFTS ARE IN EASTERN STANDARD TIME (EST)

Shift Availability Requirements

Full-Time (appr. 40+ hours per week)

Candidates must speak both Spanish and English fluently, have a pleasant speaking voice, professional mannerisms, good computer skills, reliable internet, a quiet dedicated space to work from and work well in a fast-paced environment. Medical experience, either hands-on or clerical, required to apply.Familiarity with EMR systems and practices preferred.

Minimum typing of 30 wpm is required and will be tested.

Responsibilities

• Review and process prior authorization requests for medications, procedures, and treatments.
• Verify patient insurance coverage and ensure compliance with payer guidelines.
• Communicate with healthcare providers to obtain necessary clinical documentation.
• Submit prior authorization requests to insurance companies and follow up on approvals or denials.
• Appeal denied authorizations by gathering supporting documentation and resubmitting requests.
• Maintain accurate records and documentation in electronic health records (EHR) and authorization systems.
• Educate patients and providers on authorization requirements and approval timelines.
• Stay updated on insurance policies, formularies, and industry regulations.
• Collaborate with pharmacy staff, case managers, and billing teams to ensure smooth processing.

Required Qualifications:

• High school diploma or equivalent.
• Minimum of 2 years of experience in prior authorizations, medical billing, or insurance verification.
• Experience in a medical office, pharmacy, or healthcare call center setting.
• Familiarity with Electronic Medical Records (EMR) systems (e.g., EPIC, eCW).
• Strong phone and verbal communication skills, with active listening abilities.
• Ability to multitask, set priorities, and manage time effectively.
• Customer-focused with adaptability to different personality types.
• Strong attention to detail and ability to handle high-volume workloads with accuracy.

If you are looking for a rewarding career in healthcare operations and have the required experience, we invite you to apply and join our team in Bogotá, Colombia!

Apply today! https://www.ondemandassessment.com/link/index/JB-N45OXOGDQ?u=1062055

Job Type: Full-time