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.