Virtual Texas Registered Nurse (RN)

MedCore Solutions, the healthcare division of Bizforce, is seeking a skilled and detail-oriented Virtual Nurse Assistant, licensed in Texas, to support healthcare providers with patient case reviews, prior authorizations, patient communication, and insurance appeals. The ideal candidate will have clinical experience, strong knowledge of healthcare processes, and excellent communication skills to manage tasks efficiently in a remote environment. 

• Conduct case discussions with providers to review patient care plans and gather necessary clinical details for insurance authorizations. 

• Process and secure prior authorizations for treatments, medications, diagnostic tests, and procedures from various insurance providers. 

• Communicate directly with patients as needed to obtain information, provide updates, and clarify pre-authorization or claims statuses. 

• Prepare and manage insurance appeals, ensuring accurate documentation and timely follow-up to resolve denied claims. 

• Maintain precise and updated records of patient cases, insurance correspondences, and authorization status. 

• Collaborate with physicians, billing teams, and insurance representatives to ensure a smooth and compliant workflow. 

• Adhere to HIPAA regulations, healthcare policies, and payer guidelines at all times. 

Qualifications: 

• Active and unrestricted nursing license in the State of Texas  

• Experience in prior authorization, insurance verification, and claims appeals 

• Familiarity with healthcare terminology, insurance guidelines, and patient care workflows 

• Proficiency in Electronic Health Records (EHR) systems and payer portals 

• Excellent verbal and written communication skills 

• Strong attention to detail, organizational skills, and ability to handle sensitive information with discretion 

Other Details: 

Start Date: TBD 
Schedule: Mondays – Fridays; 8 hour-shift; 40 hours/week 

Days off: Weekends 

Time zone: Central Standard Time 

Location: Work from Home 

System Requirements 

Processor: Intel Core i5 or higher, or AMD Ryzen 5 or higher 

RAM: 8GB or higher 

OS: Windows 11 Pro (Windows 10 Pro is acceptable but not preferred). OS should be a legit license 

Internet Connectivity:  At least 50 Mbps and should be wired  

Back-up connection and Power Supply 

Hard Disk: At least an SSD 

For Mac: 

Processor: Apple M1 chip 

RAM:  8GB and up 

Our Commitment to delivering high-quality results for our clients and the only way to do that is ensuring a rewarding, respectful and productive experience for our employees. We hold the same values for both our customers and our employees. 

• Permanent Work From home 

• Permanent Weekends Off 

• Great Company Culture and No Micromanagement 

• Bonuses*

Who We Are 

MedCore Solutions (MCS) provides a comprehensive suite of healthcare administration services, including medical billing, credentialing, scribing, insurance verification, compliance, and virtual staffing. Our goal is to support healthcare providers in navigating the complexities of patient care and administration effectively. 

We take pride in offering an extensive array of administrative products and training that ensure compliance and operational efficiency for healthcare practices. Our online compliance center provides easy access to a wide selection of training resources covering critical areas like OSHA, HIPAA, Patient Safety, and more.