Medical Admin VA: Prior Authorizations & Insurance Ops

Winning Assistants; Philippines; Remote; PHP 424,000 - 509,000; Full time

Benefits offered by this job

Hourly pay: USD 5–6

HIPAA training

Cybersecurity training

Work with US healthcare clients

Performance-based incentives

Job summary

Winning Assistants is seeking a detail-oriented professional in the Philippines to manage medical prior authorizations and billing support for U.S.-based practices.

You will verify insurance, review CPT codes, process referrals, and maintain accurate records in EHR/EMR systems while communicating with insurers and providers to streamline approvals and scheduling. The role requires strong English communication and the ability to manage multiple requests with discretion.

Qualifications

• Extensive experience with prior authorizations, insurance verification, and benefits verification.
• Experience managing HMO referrals and authorization workflows.
• Strong understanding of CPT codes and medical billing processes.
• Experience with U.S. healthcare practices and healthcare administration.
• Preferred vascular surgery, specialty care, or radiology authorizations experience.
• Proficient in reviewing clinical notes and gathering supporting documentation.
• Excellent organizational and time-management abilities.
• Ability to manage multiple authorizations independently.

Responsibilities

• Manage prior authorizations for vascular surgery procedures and radiology (CT, MRI, MRA, CTA, Ultrasound).
• Submit, track, and update authorization requests including TriWest and Veteran authorizations.
• Prepare and submit authorization letters with supporting clinical documentation.
• Communicate with insurance companies regarding approvals, denials, and status updates.
• Verify insurance eligibility, patient benefits, copays, deductibles, and out-of-pocket expenses.
• Handle HMO referrals and referral follow-ups.
• Generate patient cost estimates based on CPT codes and insurance coverage.
• Process and follow up on medical record requests, ensuring reports and records are received before appointments.
• Maintain accurate documentation within the EHR/EMR system and monitor internal communications related to authorizations.
• Provide administrative support including billing claims follow-up and managing documentation related to referrals, insurance, billing, and patient records.

Skills

Prior authorizations

Insurance verification

Benefits verification

HMO referrals

CPT codes

Medical billing

EHR/EMR

Organization

Communication

Attention to detail

Tools

EMR/EHR software

Billing software

Job description

Winning Assistants is seeking a detail-oriented professional in the Philippines to manage medical prior authorizations and billing support for U.S.-based practices.

You will verify insurance, review CPT codes, process referrals, and maintain accurate records in EHR/EMR systems while communicating with insurers and providers to streamline approvals and scheduling. The role requires strong English communication and the ability to manage multiple requests with discretion.