Pre-Authorization & Referral Coordinator in Brazil, Indiana at Jobgether

This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Pre-Authorization & Referral Coordinator in Brazil.

This role plays a key part in ensuring smooth access to healthcare services for patients within the U.S. insurance system. You will be responsible for managing insurance verification, prior authorizations, and referral workflows with precision and speed. The position requires close interaction with payer portals, clinical documentation, and internal systems to ensure all approvals are properly obtained before procedures or treatments. You will support a fast-paced medical environment by reducing delays, preventing claim issues, and improving patient experience. The work is highly detail-oriented and compliance-driven, requiring strong knowledge of insurance rules and medical coding. This is a remote, independent contractor role supporting a U.S.-based healthcare practice with daily operational impact.

In this role, you will manage insurance verification, authorization processes, and referral coordination to ensure patients receive timely access to covered medical services. You will work closely with insurance providers, clinical documentation, and internal systems to ensure accuracy and compliance across all steps.

• Verify active insurance coverage and review patient benefits in detail
• Determine patient financial responsibility, including copays, deductibles, and coinsurance
• Obtain and manage prior authorizations for procedures, imaging, and specialty services
• Submit and track authorization requests using payer portals such as Availity, UHC, Aetna, and Cigna
• Review and attach required clinical documentation to support approvals
• Process and monitor internal and external referrals in accordance with insurance requirements
• Ensure compliance with HMO referral rules and payer-specific guidelines
• Enter and maintain accurate authorization records in EMR/EHR systems
• Follow up on pending requests and assist in resolving authorization denials
• Communicate authorization status and insurance requirements clearly to patients

This position requires hands-on experience in U.S. healthcare administration, particularly in insurance verification and prior authorizations. The ideal candidate is highly detail-oriented, organized, and confident working with payer systems and medical documentation.

• 2+ years of experience in a U.S. medical office handling insurance verification and prior authorizations
• Proven experience independently obtaining prior authorizations
• Strong knowledge of Medicare, Medicaid, and commercial insurance plans (HMO, PPO, POS)
• Understanding of deductibles, copays, coinsurance, and out-of-pocket maximums
• Familiarity with ICD-10 and CPT coding
• Experience using payer portals such as Availity, UnitedHealthcare, Aetna, and Cigna
• Experience working with EMR/EHR systems
• Strong attention to detail and ability to manage high-volume workflows
• Excellent written and verbal English communication skills
• Reliable high-speed internet connection (100 MB minimum)
• Own computer and professional headset for remote work

• 100% remote position
• Full-time schedule (Monday to Friday)
• Weekends off
• Performance-based bonuses
• Exposure to U.S. healthcare insurance workflows
• Stable long-term remote contractor opportunity
• Structured and process-driven work environment