Medical Virtual Assistant - Prior Authorization

Job Title: Medical Virtual Assistant — Prior Authorization
Position Type: Part-Time (20 hours per week), with potential to transition to full-time
Work Hours: 10:30 AM – 2:30 PM Central Time

Work Days: Monday to Friday

Salary: 5–6 per hour, depending on experience
Workplace: Remote
Preferred Candidate Location: Philippines

About the Client & Role

Our client is a U.S.-based psychiatry and behavioral health practice seeking a reliable, experienced, and highly organized Medical Virtual Assistant — Prior Authorization to manage medication prior authorizations, insurance eligibility and copay verification, clinical documentation preparation, and medical administrative paperwork. The practice serves a substantial Medicare and Medicaid patient population and needs someone who can independently navigate payer requirements, resolve authorization issues, and reduce administrative backlogs without constant supervision.

The position will initially be part-time at 20 hours per week, with the possibility of transitioning to full-time after approximately 2–3 weeks based on performance and practice needs. The ideal candidate has hands-on prior authorization and insurance verification experience, strong technical skills, excellent follow-through, and the ability to learn practice-specific workflows quickly. The client's primary goal is to reduce administrative interruptions and allow the provider to focus on patient care and clinical documentation.

Scope of Work / Responsibilities

Prior Authorizations — Primary Priority

• Independently prepare, submit, and follow up on medication prior authorization requests, including those involving Medicare and Medicaid.
• Review payer requirements, required clinical documentation, and authorization status to help prevent processing delays.
• Communicate with insurance companies, pharmacy benefit managers, and pharmaceutical support programs to resolve outstanding requests.
• Track pending, approved, and denied authorizations, ensuring timely follow-ups and appropriate escalation.
• Maintain accurate authorization records and supporting documentation in the EHR.
• Assist with authorization-related issues using CoverMyMeds or applicable insurance portals.

Insurance Eligibility & Copay Verification

• Verify patient insurance eligibility, active coverage, benefits, and copay amounts before appointments.
• Navigate Medicare, Medicaid, and commercial insurance portals to confirm coverage requirements.
• Contact insurance representatives to resolve discrepancies, clarify benefits, and confirm patient financial responsibilities.
• Document verified coverage and copay information accurately in the patient record.
• Perform insurance verification independently, including when the practice's biller is unavailable.
• Flag unresolved eligibility or payment concerns for appropriate follow-up.

Clinical Documentation & Administrative Paperwork

• Prepare clinical note templates and transfer selected information from existing documentation or AI-generated notes into the EHR for provider review and completion.
• Update and organize established templates without independently interpreting clinical findings or finalizing medical documentation.
• Prepare demographic and administrative sections of FMLA and short-term disability forms for provider review and signature.
• Draft return-to-work and return-to-school letters using approved templates and provider-supplied information.
• Prepare lab requisitions and related administrative documentation for provider approval.
• Maintain accurate patient records and coordinate documentation tasks with the in-person office assistant.

Medical Administration & Patient Coordination

• Monitor prescription refill requests and route them to the appropriate clinical staff for review.
• Assist with patient intake forms, appointment scheduling, and virtual appointment links as needed.
• Organize and route patient requests, outstanding documentation, and administrative tasks to appropriate team members.
• Answer patient calls and record messages when priority authorization, insurance, and documentation responsibilities are caught up.
• Maintain organized task lists and follow up on outstanding administrative requirements.

Daily Communication & Workflow Management

• Participate in a daily phone check-in with the provider or office assistant to review priorities and outstanding tasks.
• Send start-of-day and end-of-day availability updates through WhatsApp.
• Provide task status updates using the practice's existing WhatsApp staff groups.
• Report unresolved issues, delays, and work interruptions promptly.
• Attend Google Meet training sessions as needed and apply practice-specific instructions independently.

Tools You'll Use

• TherapyNotes — Current EHR/EMR system; the practice may transition to another platform
• CoverMyMeds — Medication prior authorization management
• Medicare, Medicaid, and commercial insurance portals
• RingCentral — Phone communication
• WhatsApp — Daily check-ins and task coordination
• GoogleMeet — Training and meetings

Requirements

Experience Requirements

• Medication Prior Authorization Experience: Required. Candidates must have demonstrated hands-on experience processing and following up on medication prior authorizations, navigating payer requirements, and resolving pending or denied requests independently. Experience with Medicare and Medicaid authorizations is highly preferred.

• Insurance Verification & Copay Experience: Required. Candidates must have experience verifying insurance eligibility, benefits, coverage, and copay amounts using payer portals and insurance representative calls.

• Healthcare Administrative Experience: Required. Candidates must have previous experience supporting U.S. healthcare practices with medical documentation, insurance coordination, patient records, and administrative workflows.

• EHR / EMR Experience: Required. Candidates must be proficient in navigating electronic health records, updating patient information, and organizing medical documentation. TherapyNotes experience is preferred but not required.

• Medical Documentation & Template Management: Required. Candidates must be comfortable updating existing medical templates, transferring documentation into EHR systems, and preparing administrative paperwork accurately for provider review.

• Technical & Computer Proficiency: Required. Candidates must have strong computer skills, be comfortable navigating multiple software platforms, and be able to learn new systems quickly without extensive technical assistance.

• CoverMyMeds Experience: Highly preferred. Familiarity with medication prior authorization submissions and follow-ups through CoverMyMeds is a strong advantage.

• Medicare & Medicaid Experience: Highly preferred. Candidates with direct experience handling medication authorizations, eligibility verification, and payer requirements involving Medicare or Medicaid will be prioritized.

• Psychiatry / Behavioral Health Experience: Preferred. Familiarity with psychiatric medication authorization workflows and behavioral health practice administration is an advantage.

• Administrative Forms Experience: Preferred. Experience preparing FMLA, short-term disability, return-to-work/school letters, or lab requisitions is beneficial.

Performance Expectations

The ideal candidate should help support:

• Timely and accurate processing of medication prior authorizations.
• Consistent follow-up on outstanding insurance and authorization requests.
• Accurate insurance eligibility, benefit, and copay verification.
• Reduced administrative backlog and fewer interruptions to the provider's clinical workflow.
• Accurate preparation of clinical templates and administrative paperwork for provider review.
• Reliable attendance, daily check-ins, and proactive communication.
• Independent completion of assigned tasks after initial practice-specific training.

Basic Requirements

• Must speak and write English clearly and professionally.
• Must have relevant work experience.
• Must be able to provide an NBI Clearance and/or Local Police Clearance before onboarding (mandatory).
• Must be available to attend video meetings with camera on when required.

Technical Requirements

• Computer: Reliable laptop or desktop computer.
• Internet: Stable high-speed internet connection (minimum 25 Mbps).
• Audio: Noise-canceling headset.
• Video: Working webcam for virtual meetings.
• Workspace: Quiet and professional work environment.

Benefits

• Dedicated HR & Contractor Support Team: Access to world-class support for questions, guidance, contract matters, and client communication.
• Premium VPN Access (Optional): A secure VPN license can be provided upon request to enhance privacy and security for client-related tasks.
• HIPAA & Cybersecurity Training + Certification (Provided): Access to our internal HIPAA compliance training, cybersecurity modules, and certification to help you confidently handle PHI for U.S. healthcare clients.
• Top 1% VA Performance Training: Access to our proprietary training on communication, client management, productivity systems, and best practices to help you become a top-performing VA and increase long-term client retention.
• Client-Approved U.S. Holidays: Contractors may take U.S. holidays off according to the client’s needs and schedule.
• Client-Approved Paid or Unpaid Time Off: Time off may be granted by your client. Paid time off is optional and only if offered by the client.
• Access to Tools & Resources: Templates, workflow guides, productivity tools, and client-specific SOP support to help you perform at your best.
• Optional Performance-Based Incentives: Some clients may offer bonuses, incentives, or increased hours based on your performance.

These are optional resources and client-approved allowances available to you as an independent contractor. Any resources, training, or allowances listed are optional contractor perks and not employee benefits.

Originally posted on Himalayas