Clinical Insurance & Authorization Specialist
Industry: Skilled Nursing / Healthcare
Position: Full-Time, Remote 9am-5pm EST
Pay: $1100-1300 USD monthly
About the Role
We are seeking a Clinical Insurance & Authorization Specialist to support the reimbursement department of a healthcare organization managing multiple skilled nursing facilities across the United States.
This role is adecuado for someone with a nursing, medical assistant, or other clinical healthcare background who is comfortable communicating with insurance companies and learning the administrative and reimbursement side of U.S. healthcare.
The specialist will work closely with an experienced nurse who will provide training on the organization's insurance contracts, authorization requirements, payer criteria, and reimbursement processes.
Key Responsibilities
- Contact insurance companies to obtain and follow up on patient authorizations.
- Review clinical information and understand whether patients meet payer criteria for continued coverage.




- Communicate confidently with insurance representatives regarding patient cases, coverage, and authorization requirements.
- Assist with retroactive authorizations and claims when necessary.
- Review and understand insurance contracts, payer requirements, and different reimbursement levels.
- Advocate for patient cases by clearly communicating relevant clinical information to insurance companies.
- Track outstanding authorizations, insurance issues, and follow-ups to ensure nothing falls through the cracks.
- Maintain accurate documentation of calls, authorizations, payer decisions, and required next steps.
- Work closely with the reimbursement team and nursing staff to obtain any clinical information required by insurance companies.
- Support insurance and reimbursement processes across multiple skilled nursing facilities.

Qualifications
- Nursing, medical assistant, or other clinical/medical background strongly preferred.
- Strong understanding of medical termino

📌 Clinical Insurance (Ciudad de México)
🏢 Remote Hive
📍 Ciudad de México