Prior Authorization – Billing Specialist

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

📋 Description

• Manage, process, track, and follow up on prior authorization requests.

• Respond to and triage incoming patient calls.

• Collect patient information, address general inquiries, and direct concerns to the appropriate healthcare personnel.

• Handle prescription refill requests and collaborate with healthcare providers for approval.

• Oversee pending prescription requests to ensure timely follow-up.

• Administer end-to-end medical billing, which includes claims preparation, submission, routing, payment posting, status monitoring, and follow-ups on outstanding or denied claims.

• Verify patient insurance eligibility, benefits, and coverage manually when corrections are needed for insurance information or package selections in Athena EHR.

• Assist with overflow patient calls during peak periods.

• Maintain accurate records of patient information, insurance details, authorization statuses, and billing documentation in the practice’s EHR system.

• Coordinate with healthcare providers, insurance representatives, pharmacies, and internal team members.

• Ensure accuracy, confidentiality, and compliance with HIPAA regulations when handling patient information.

⛳️ Requirements

• A minimum of 1 year of experience in medical virtual assistance, healthcare administration, medical billing, prior authorization, or a similar healthcare-related role.

• Strong understanding of medical administrative workflows.

• Willingness to undergo training for practice-specific procedures.

• Experience in handling patient calls, triage, intake, and patient coordination.

• Knowledge of prescription refill workflows, insurance eligibility verification, and medical claims processes.

• Excellent English communication skills, both written and verbal.

• Strong organizational skills and meticulous attention to detail.

• Ability to efficiently manage multiple responsibilities.

• Capability to work independently in a remote healthcare setting while ensuring patient confidentiality.

• Must clearly and professionally speak and write in English.

• Relevant work experience is required.

• Must be able to provide an NBI Clearance and/or Local Police Clearance prior to onboarding.

• Availability to attend video meetings with the camera on when necessary.

• A reliable laptop or desktop computer is required.

• Stable high-speed internet connection (minimum 25 Mbps) is essential.

• A 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.

• Bonuses, incentives, or increased hours may be offered based on performance.