Medical Virtual Assistant - Prior Authorization

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
* Google Meet — 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.