# Wound Care Insurance Verification Specialist (Remote)

> NIVA Health · South Africa (Remote) · Full-time · Posted 2026-07-09

**Workplace:** remote

**Department:** NIVA Wound Care

## Description

**Wound Care Insurance Verification Specialist (Remote)**

Do you have a meticulous eye for detail and a passion for helping patients access the care they need? Are you experienced in navigating insurance guidelines, prior authorizations, and the specialized world of wound care? If so, **NIVA Health** invites you to apply for our Remote Insurance Verification Specialist position!

At NIVA Health, our mission is simple: helping people heal. Every day, our nationwide team stands shoulder to shoulder, delivering compassionate, expert care to patients who deserve to live healthier, fuller lives. As a key member of our authorization coordination team, you will play a pivotal role in ensuring patients receive timely, necessary treatment, all while exemplifying our Core Values of Teamwork, Resilience, Open-Mindedness, Ownership, and Positivity.

**In This Role, You’ll:**

-   Submit and manage prior authorization requests for wound care treatments, ensuring that all documentation meets payer requirements.
-   Handle PCP referrals/authorizations and follow up to facilitate smooth patient care.
-   Prepare and track Single Case Agreements/GAP exceptions for out-of-network cases.
-   Communicate with insurance providers to clarify coverage, resolve denials, and facilitate appeals.
-   Maintain precise records of authorizations, denials, appeals, and corresponding documentation.
-   Stay up to date with insurance policies, coding changes, and criteria for wound care procedures.
-   Collaborate with healthcare providers, nurses, and admin staff to gather complete, accurate documentation for submissions.
-   Serve as a patient advocate, keeping patients informed about the status of their authorizations and potential out-of-pocket expenses.
-   Conduct your work with utmost discretion, diplomacy, and tact during all patient and staff interactions.
-   Contribute to other duties of similar complexity as assigned by your supervisor.

**You’re a Great Fit If You:**

-   Possess at least 1 year of experience in prior authorization management, **specifically within wound care services**.
-   Demonstrate a strong work ethic, self-motivation, and a “can-do” attitude.
-   Communicate clearly, empathetically, and professionally with patients, staff, and payers.
-   Understand the intricacies of insurance processes, medical terminology, and healthcare systems.
-   Are proficient with electronic medical records (EMR) and case management software.
-   Excel at collaborating with multidisciplinary healthcare teams and solving complex problems.
-   Embody NIVA Health’s Core Values in every interaction with patients and colleagues.

**Bonus Points If You:**

-   Are experienced in handling appeals, denials, and single case agreements.
-   Bring innovative approaches to patient advocacy and insurance coordination.
-   Stay informed about industry trends, especially in advanced wound care and insurance policy changes.

**Why Join Us?**

At NIVA Health, your efforts are instrumental in ensuring that patients receive the life-changing care they deserve. We celebrate our team’s achievements, invest in personal and professional growth, and provide meaningful work in a values-driven, supportive environment. Learn more about us at [https://nivahealthwoundcare.com/](https://nivahealthwoundcare.com/) and become part of NIVA Health’s mission to _redefine patient care—one healing wound at a time._

**Pay:** $1,300 per month

**Work Schedule:** US Timezone (East Coast)

**Job Type:** Full-time

**Work Location:** Remote

## Apply

[Apply at NIVA Health](https://apply.workable.com/niva-health-2/j/10777D8F8C/apply)

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