Medical Virtual Assistant – Prior Authorization, Billing Support

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

📋 Description

• Oversee prior authorization requests from the initial submission to follow-up and resolution

• Monitor pending authorizations and follow up on both approvals and denials

• Support medical billing and tasks related to claims

• Analyze denied claims and investigate issues such as missing authorizations, incorrect patient details, and other discrepancies

• Address outstanding claim holds and rectify issues prior to submission or resubmission

• Ensure accurate and current documentation is maintained in Athena EHR

• Manage both incoming and outgoing faxes via Athena

• Oversee and process orders alongside assigned healthcare administrative responsibilities

• Provide additional phone support and assist with patient inquiries

• Aid with scheduling requests and direct patients to the appropriate team member

• Handle non-controlled medication refill requests and coordinate with the clinical team

• Collaborate with onsite medical assistants and other team members

• Utilize Spruce for patient phone communication and coordination

• Complete all work accurately and punctually, including authorizations, daily tasks, Athena orders and faxes, Spruce calls, claims, and claim holds

⛳️ Requirements

• Practical experience with Athena EHR / athenahealth

• Background in primary care

• Proficiency in managing prior authorizations

• Knowledge of medical billing, claims processing, denied claims, or claims resolution

• Experience in healthcare administration or as a Medical Virtual Assistant

• Excellent spoken and written English communication skills

• Clear and patient communication over the phone

• Strong attention to detail and commitment to follow-through

• Ability to manage multiple tasks and collaborate effectively with a healthcare team

• Familiarity with Spruce Health (preferred)

• Experience in home health, mobile primary care, palliative care, geriatric care, or other home-based healthcare environments (preferred)

• Experience supporting elderly or geriatric patients (preferred)

• Experience managing Athena faxes, orders, and claim holds (preferred)

• Must possess clear and professional spoken and written English skills

• Must have relevant work experience

• Must provide NBI Clearance and/or Local Police Clearance prior to onboarding

• Must be available for video meetings with the camera on as required

• Reliable laptop or desktop computer is necessary

• Stable high-speed internet connection with a minimum of 25 Mbps is required

• Noise-canceling headset is necessary

• A working webcam for virtual meetings is required

• A quiet and professional work environment is essential

🏝️ Benefits

• Dedicated HR & Contractor Support Team

• Optional Premium VPN Access

• HIPAA & Cybersecurity Training + Certification (Provided)

• Top 1% VA Performance Training

• Client-Approved U.S. Holidays

• Client-Approved Paid or Unpaid Time Off

• Access to Tools & Resources

• Optional Performance-Based Incentives

• Some clients may offer bonuses, incentives, or increased hours based on performance