Virtual Healthcare Coordinator

About the role

We are looking for a Virtual Healthcare Coordinator to support US‑based healthcare providers. The ideal candidate has experience in US healthcare operations such as scheduling, eligibility checks, prior authorizations and insurance verification. This remote professional will act as a critical liaison between patients, providers and insurers.

Key responsibilities

• Conduct eligibility checking and benefits verification for patients before appointments.
• Interpret insurance policies (PPO, HMO, Medicare/Medicaid) and determine patient financial responsibilities.
• Prepare and submit prior‑authorization requests via web portals, fax or phone.
• Review clinical documentation to ensure medical‑necessity criteria are met.
• Track pending authorizations, manage appeals for denied claims and expedite urgent requests.
• Handle inbound and outbound calls to schedule, reschedule and remind patients of wellness visits.

Required profile

• Resident of the Great Metropolitan Area (GAM) in Costa Rica with a reliable work‑from‑home setup.
• Minimum 1 year of direct experience in US healthcare scheduling, eligibility verification and prior authorizations.
• Deep understanding of US insurance concepts, including PPO, HMO, EOBs, copays and patient benefits.
• Strong analytical skills, exceptional attention to detail and excellent written and verbal English communication.
• Ability to work independently in a fast‑paced environment.

Required skills

• Navigation of insurance portals such as Availity, Optum and CoverMyMeds.
• Use of electronic health record / practice management systems like ECW, Tebra and Dentrix.