Medical Virtual Assistant – Claims Management, Prior Authorization, Referrals

This is a fully remote position, open to applicants in Philippines.

📋 Description

• Manage the intake process for new client inquiries and referrals.

• Reach out to potential clients within 24–48 hours of receiving their inquiries.

• Complete the intake processing within a timeframe of 7–10 days.

• Collaborate with referral sources and ensure ongoing communication.

• Handle referrals from platforms such as Psychology Today and healthcare providers.

• Submit and oversee Medicaid prior authorizations.

• Follow up on denied claims and address any billing issues.

• Monitor authorization status and secure timely approvals.

• Interact with insurance companies regarding the status and requirements of claims.

• Confirm client insurance details and benefits.

• Ensure claims are correctly established and submitted without errors.

• Evaluate billing information for thoroughness and accuracy.

• Collaborate with commercial insurance platforms, including Blue Cross Blue Shield and other payers.

• Act as a virtual receptionist by responding to and managing incoming calls.

• Conduct outbound calls to prospective clients and referral sources.

• Schedule appointments and send out reminders for those appointments.

• Assist with the collection of payments and follow up on accounts as needed.

• Deliver outstanding customer service to clients and stakeholders.

• Perform data entry and keep accurate records.

• Manage workflows and task tracking using Trello.

• Update client details within the SimplePractice EHR system.

• Provide support for general administrative and operational tasks.

• Work independently while achieving set performance objectives.

⛳️ Requirements

• Background in healthcare administration, medical virtual assistance, or a similar healthcare support position.

• Experience in managing prior authorizations, insurance verification, referrals, or medical claims.

• Excellent phone communication skills along with strong customer service abilities.

• Outstanding organizational skills and meticulous attention to detail.

• Capability to work independently and demonstrate initiative.

• Strong skills in follow-up and problem-solving.

• Knowledge of HIPAA regulations and the importance of patient confidentiality.

• Proficient with Google Workspace and various web-based applications.

• Familiarity with SimplePractice EHR is preferred.

• Experience utilizing Trello for workflow management is preferred.

• Knowledge of Google Voice is preferred.

• Experience with Medicaid and commercial insurance plans is preferred.

• Prior experience in appointment scheduling, customer service, account management, or healthcare call center settings is preferred.

🏝️ Benefits

• Dedicated HR & Contractor Support Team: Benefit from exceptional support for inquiries, guidance, contract issues, and client communication.

• Premium VPN Access (Optional): A secure VPN license can be requested to enhance privacy and security during client-related tasks.

• HIPAA & Cybersecurity Training + Certification (Provided): Access to our internal HIPAA compliance training, cybersecurity modules, and certification to confidently manage PHI for U.S. healthcare clients.

• Top 1% VA Performance Training: Gain access to our exclusive training on communication, client management, productivity systems, and best practices to excel as a top-performing VA and improve long-term client retention.

• Client-Approved U.S. Holidays: Contractors may take U.S. holidays off as per the client’s requirements and schedule.

• Client-Approved Paid or Unpaid Time Off: Time off may be granted by your client, with paid time off being optional and contingent upon the client's offer.

• Access to Tools & Resources: Utilize templates, workflow guides, productivity tools, and client-specific SOP support to maximize your performance.

• Optional Performance-Based Incentives: Some clients may provide bonuses, incentives, or increased hours based on your performance.