Medical VA | Prior Authorization Specialist

Global Medical Virtual Assistants

Quezon City

Remote

PHP 562,000 - 702,000

Full time

3 days ago

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Benefits offered by this job

Free Training

Paid Time Offs

HMO Coverage

Optical Rewards

Performance-Based Increase

Permanent Work From Home

Job summary

Global Medical Virtual Assistants is seeking a Medical Virtual Assistant – Prior Authorization Specialist to manage end-to-end prior authorizations for healthcare providers. You will liaise between providers, insurance payors, and patients to secure timely approvals, supporting patient access and revenue cycle efficiency.

Role requires 6 months to 1 year of US healthcare BPO experience, HIPAA awareness, strong time management, and attention to detail.

Qualifications

Minimum of 6 months to 1 year of prior authorization or healthcare BPO experience handling US healthcare accounts.
Familiarity with insurance portals, EMR/EHR systems, and medical terminology.
HIPAA certification is a plus
Excellent time management
Strong attention to detail
Computer savvy
Willing to work night shifts

Responsibilities

Submit, track, and follow up on prior authorization requests.
Interface with insurance companies to verify requirements and status.
Verify patient coverage, benefits, and plan specifics before scheduling.
Retrieve medical history, notes, and diagnostic reports.
Serve as primary contact between providers, patients, and payors.
Identify denial reasons, gather missing data, and prepare basic appeals.
Provide back-office support including data entry and record management.
Strictly follow HIPAA and keep patient data confidential.

Skills

Time management

Attention to detail

Computer skills

Night shift availability

HIPAA knowledge

Job description

A Medical Virtual Assistant – Prior Authorization Specialist manages the end-to-end prior authorization process for our healthcare practitioners. You will serve as the primary liaison between healthcare providers, insurance companies, and patients to ensure timely approvals for procedures, medications, diagnostic testing, and specialist referrals. Your work will directly impact patient care access, practice workflow, and revenue cycle efficiency.

TASKS:

Submitting, tracking, and following up on prior authorization requests.
Managing inbound and outbound calls with healthcare insurance companies to verify authorization requirements, check status updates, and resolve pending or denied requests.
Verifying patient healthcare insurance coverage, benefits, and specific plan requirements prior to scheduling procedures or submitting authorizations.
Retrieving relevant medical history, clinical notes, and diagnostic reports.
Acting as the primary point of contact between medical providers, patients, and payors.
Identifying reasons for authorization denials, gathering missing clinical information, and preparing basic appeal packages under the direction of healthcare providers.
Providing specialized back-office support, including data entry, email management, authorization tracking log maintenance, and record management.
Strictly adhering to HIPAA regulations and maintaining confidentiality across all patient data, insurance details, and communications.

QUALIFICATIONS:

Minimum of 6 months to 1 year of prior authorization or healthcare BPO experience handling US healthcare accounts.
Strong familiarity with insurance portals, EMR/EHR systems, and medical terminology.
HIPAA Certification is a plus
Excellent time management
Strong attention to detail
Computer savvy
Great work attitude and willingness to go the extra mile
Open to working night shifts

MINIMUM SYSTEM REQUIREMENTS

PRIMARY SYSTEM
- Computer Processor: Intel Core i5-6000 (6th Gen or higher) or AMD Ryzen 5 or higher
- Computer Memory/RAM: 8.00 GB
- Computer Operating System: At least Windows 11 64-bit or macOS Ventura
- Headset: Any USB-type headset with noise-cancelling feature
- Camera: Capable of a clear and crisp video output
BACK-UP SYSTEM
- OPTION 1 (BACKUP SYSTEM):
  - Computer Processor: Intel Core i5-6000 (6th Gen or higher) or AMD Ryzen 5 or higher
  - Computer Memory/RAM: 8.00 GB
  - Computer Operating System: at least Windows 11 64-bit or macOS Ventura
  - Headset: Any USB-type headset with noise-cancelling feature (Optional)
- OPTION 2 (POWER SUPPLY - UPS):
  - Must be capable of powering your work station for at least 3 hours
  - Typically a device with 240Wh or higher will be sufficient
  - Must be capable of accepting all the plugs required to maintain the primary device and work environment (device, monitor, modem, cell phone if using as internet backup)
PRIMARY INTERNET CONNECTION
- DSL / Fiber Connection - Minimum of 100mb/s contracted
BACK-UP INTERNET CONNECTION
- Minimum of 20mb/s (Cell)

RECOMMENDED SYSTEM REQUIREMENTS

PRIMARY SYSTEM
- Computer Processor: Intel Core i7 and i9 Core or Core Ultra or AMD Ryzen 7 or higher
- Computer Memory/RAM: 16.00 GB
- Computer Operating System: At least Windows 11 64-bit or macOS Tahoe
- Headset: Any USB-type headset with noise-cancelling feature
- Camera: Capable of a clear and crisp video output
BACK-UP SYSTEM
- OPTION 1 (BACKUP SYSTEM):
  - Computer Processor: Intel Core i7 and i9 Core or Core Ultra or AMD Ryzen 7 or higher
  - Computer Memory/RAM: 16.00 GB
  - Computer Operating System: At least Windows 11 64-bit or macOS Tahoe
  - Headset: Any USB-type headset with noise-cancelling feature
  - Camera: Capable of a clear and crisp video output
- OPTION 2 (POWER SUPPLY - UPS):
  - Must be capable of powering your work station for at least 3 hours
  - Typically a device with 240Wh or higher will be sufficient
  - Must be capable of accepting all the plugs required to maintain the primary device and work environment (device, monitor, modem, cell phone if using as internet backup)
PRIMARY INTERNET CONNECTION
- DSL / Fiber Connection - Minimum of 500mb/s contracted
BACK-UP INTERNET CONNECTION
- Minimum of 20mb/s (Cell or wired)