Medical Virtual Assistant – Outbound Calls, Prior Authorization

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

📋 Description

• Process, validate, and manage prescription refill requests.

• Communicate the outcomes of refills to both patients and pharmacies.

• Monitor and administer refill queues using Athena.

• Reconcile any duplicate, closed, or pending refill items between the pharmacy and provider.

• Identify medications that require prior authorization.

• Utilize CoverMyMeds for requests related to medications.

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

• Follow up on pending authorizations and their approval statuses.

• Coordinate with providers regarding approvals, denials, and requests for additional information.

• Accurately process appeals and document updates in Athena.

• Identify any delays or issues associated with CoverMyMeds and Evicore.

• Conduct outbound calls for appointment reminders, updates, and follow-up needs.

• Relay provider instructions and clinic updates in a professional manner.

• Adhere to HIPAA-compliant voicemail practices.

• Address patient inquiries concerning symptoms, devices, test results, or subsequent steps.

• Document patient acknowledgments, pending issues, and follow-up requirements.

• Schedule or reschedule patient appointments as necessary.

• Upload and organize documents received from external facilities.

• Manage discharge summaries, imaging results, clinical notes, and lab-related documents efficiently.

• Notify providers of any urgent symptoms or patient requests.

• Request lab results from external labs and track pending items accordingly.

• Route clinical information to the appropriate team member.

• Maintain thorough documentation in both inbox and outbox.

• Close completed tasks in an efficient and accurate manner.

• Report any system access issues or workflow delays encountered.

• Route tasks appropriately to clinical, billing, or provider teams.

• Ensure documentation is clear, updated, and easy to follow.

⛳️ Requirements

• Minimum of 1 year of experience as a Medical Virtual Assistant, Clinical Support VA, Medical Assistant, or in a similar capacity.

• Hands-on experience with Athena is essential.

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

• Excellent outbound calling skills with professional communication abilities.

• Prior authorization experience is required.

• Strong skills in documentation accuracy and task management.

• Ability to work independently in a fast-paced clinic setting.

• Familiarity with CoverMyMeds is necessary.

• Capability to communicate effectively with patients, pharmacies, providers, and insurance representatives.

• Experience in charting or clinical documentation is essential.

• Preference given to those with CoverMyMeds experience.

• Experience with Google Voice is a plus.

• Familiarity with payer portals or insurance verification tools is advantageous.

• Prior experience in Family Medicine or Primary Care is a nice-to-have.

• Experience with authorizations for chronic care and weight management medications is a plus.

• Familiarity with requesting records, lab results, imaging results, or discharge summaries is a bonus.

🏝️ Benefits

• Competitive salary and opportunities for professional growth.

• Comprehensive health benefits package.

• Flexible work schedule and remote work opportunities.

• Supportive and collaborative work environment.