Medical Virtual Assistant, Outbound Calls, Prior Authorization

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

📋 Description

• Process, validate, route, and track prescription refill requests using Athena.

• Communicate refill outcomes to both patients and pharmacies.

• Identify and manage medication prior authorizations through CoverMyMeds.

• Submit, track, and appeal prior authorizations for medications related to chronic care and weight management.

• Coordinate authorization approvals, denials, and information requests with healthcare providers.

• Assist with claims processing and follow up with insurance providers.

• Review and follow up on denied, rejected, or pending claims via payer portals and insurance channels.

• Conduct outbound calls for appointment reminders, updates, and necessary follow-ups.

• Relay provider instructions and clinic updates to patients effectively.

• Respond to patient inquiries and document acknowledgments, concerns, and follow-up requirements.

• Schedule or reschedule patient appointments as needed.

• Upload and organize external clinical documents, including discharge summaries, imaging results, clinical notes, and lab-related documents.

• Notify providers regarding urgent symptoms or patient requests.

• Request and track external lab results promptly.

• Maintain accurate documentation in both inbox and outbox, routing tasks to the appropriate teams.

• Report any system access issues or workflow delays and keep documentation up to date.

⛳️ Requirements

• A minimum of 1 year of experience as a Medical Virtual Assistant, Clinical Support VA, Medical Assistant, or in a similar role.

• Proven hands-on experience with Athena is essential.

• Strong experience navigating Athena task queues, documentation, charting, patient records, and clinical workflows.

• Excellent outbound calling skills and professional communication abilities.

• Experience with prior authorizations is necessary.

• Background in claims processing or insurance follow-up is required.

• Strong skills in documentation accuracy and task management.

• Ability to work independently in a dynamic clinic environment.

• Familiarity with CoverMyMeds is beneficial.

• Experience in charting or clinical documentation is required.

• Comfortable communicating with patients, pharmacies, providers, and insurance representatives.

• Experience with CoverMyMeds is highly preferred.

• Knowledge of Google Voice is preferred.

• Experience using payer portals or insurance verification tools is a plus.

• Experience in Family Medicine or Primary Care is a nice addition.

• Familiarity with chronic-care or weight-management medication authorizations is advantageous.

• Previous experience following up on denied or pending claims is a plus.

• Experience requesting records, lab results, imaging results, or discharge summaries is beneficial.

• Must ensure HIPAA-compliant communication at all times.

🏝️ Benefits

• Competitive salary and comprehensive benefits package.

• Opportunity for professional development and growth.

• Flexible working hours to support work-life balance.

• Collaborative and supportive work environment.