Insurance Specialist – Medellín, CO
Full Time – On-site

RV Staffing, a growing healthcare organization focused on delivering high-quality, patient-centered care through efficient and compliant clinical operations. Our teams support multiple medical specialties and rely on accurate, well-organized medical records to ensure continuity of care, timely authorizations, and audit readiness. As we continue to scale, we’re looking for detail-oriented professionals who take ownership of documentation integrity and thrive in regulated, on-site environments.

We are currently seeking an Insurance Specialist that verifies patient coverage, obtains prior authorizations, and ensures medical services are billed correctly. You'll work with patients, providers, and insurance companies to resolve claims, denials, and payment issues while staying compliant with healthcare regulations.

Position Summary:

The Insurance Specialist plays a key role in ensuring patients receive timely access to care by verifying benefits, securing prior authorizations, and communicating coverage details clearly to patients and providers. This position requires strong knowledge of insurance processes, medical terminology, and attention to detail. The specialist works closely with physicians, office managers, and staff to support efficient patient care and practice operations.

What You’ll Do:

Insurance Verification & Benefits
● Review patients’ insurance information and confirm accuracy in the system.
● Verify benefits through payer portals or phone calls.
● Confirm coverage for requested treatments, procedures, or medications.
● Communicate coverage information to patients and providers, including financial responsibility.
● Determine if a referral is required and obtain it from the PCP when necessary.
Prior Authorization
● Review patients’ medical records to confirm medical necessity and compliance with policy guidelines.
● Determine if prior authorization is required for requested services.
● Collect and prepare required documentation: demographics, clinical notes, imaging, CPT/ICD-10 codes, insurance details, and physician information (tax ID, NPI, contacts).
● Submit prior authorization requests to payers, ensuring accuracy and completeness.
● Track and follow up on pending requests to ensure timely approvals.
● Upload authorization letters (approved or denied) to patient charts.
● Coordinate P2P (peer-to-peer) reviews when required.
● Review denial letters, request missing documentation from providers, and initiate appeals as appropriate.
Communication & Coordination
● Keep patients informed regarding insurance coverage, out-of-pocket costs, and authorization outcomes.
● Communicate payer decisions promptly to providers, staff, and office managers.
● Respond to general requests from doctors, office managers, and staff related to insurance or authorizations.
● Check daily for add-ons or cancellations that may affect authorizations.

What You’ll Bring to the Team

● Strong knowledge of medical insurance plans, coverage rules, and authorization processes.
● Familiarity with CPT codes, ICD-10 codes, and clinical documentation standards.
● Experience working with EMR/EHR systems (e.g., ECW).
● Excellent organizational skills with strong attention to detail.
● Effective communication skills with patients, providers, and insurance representatives.
● Ability to handle sensitive patient and financial information with confidentiality.

We Offer You

● On-site positions with great Monday to Friday Schedules
● Competitive salaries in USD, based on experience.
● Direct Hire/Independent Employee agreement.
● Equipment
● A collaborative environment with opportunities to grow and make a real impact.

Insurance Specialist (On-site, English)