Medical Virtual Assistant – Outbound Calls, Prior Authorization

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

📋 Description

• Process, validate, and direct prescription refill requests.

• Communicate the outcomes of refills to patients and pharmacies.

• Monitor and manage refill queues using Athena.

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

• Identify medications that require prior authorization.

• Maintain and actively utilize CoverMyMeds for medication-related requests.

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

• Follow up on pending authorizations and verify approval statuses.

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

• Process appeals and accurately document updates in Athena.

• Identify delays or issues with CoverMyMeds and Evicore.

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

• Professionally relay provider instructions and clinic updates.

• Utilize HIPAA-compliant voicemail practices.

• Address patient inquiries regarding symptoms, devices, test results, or next steps.

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

• Schedule or reschedule appointments as needed.

• Upload and organize documents from external facilities.

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

• Notify providers of urgent symptoms or patient requests.

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

• Route clinical information to the appropriate team member.

• Maintain accurate documentation in both inbox and outbox.

• Close completed tasks efficiently and correctly.

• Report any system access issues or workflow delays.

• Assign tasks to the relevant clinical, billing, or provider team.

• 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 a similar role.

• Demonstrated hands-on experience with Athena is essential.

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

• Excellent outbound calling skills and professional communication abilities.

• Experience with prior authorization processes.

• High level of accuracy in documentation and task management skills.

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

• Familiarity with CoverMyMeds is important.

• Experience in charting or clinical documentation.

• Comfort in communicating with patients, pharmacies, providers, and insurance representatives.

• Preference for candidates with CoverMyMeds experience.

• Experience with Google Voice is a plus.

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

• Experience in Family Medicine or Primary Care is desirable.

• Background in handling prior authorizations for chronic care or weight management medications is a plus.

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

• Ability to maintain HIPAA-compliant communication.

🏝️ Benefits

• Competitive salary and comprehensive benefits package.

• Opportunities for professional development and growth.

• Supportive and collaborative work environment.

• Flexible working hours and remote work options.