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…