Prior Authorization & Billing Specialist

Winning Assistants LLC; Philippines; À distance; PHP 439 000 - 526 000; Plein temps

Avantages offerts par ce poste

Dedicated HR & Contractor Support Team

Premium VPN Access

HIPAA & Cybersecurity Training + CERT

Top VA Performance Training

Client-Approved U.S. Holidays

Client-Approved Paid/Unpaid Time Off

Access to Tools & Resources

Résumé du poste

Winning Assistants LLC is seeking a Prior Authorization & Billing Specialist to join our remote healthcare support team. You will manage prior authorization requests, process referrals, and oversee end-to-end medical billing, claims, and insurance verification for U.S.

clients with HIPAA-compliant practices. Ideal candidates have 1+ year in medical administration, excellent English, and strong organizational skills.

Qualifications

• At least 1 year of experience in medical virtual assistance, healthcare administration, medical billing, prior authorization, or a similar healthcare-related role.
• Strong understanding of medical administrative workflows, with willingness to undergo training for practice-specific processes.
• Experience handling patient calls, triage, intake, and patient coordination.
• Knowledge of prescription refill workflows, insurance eligibility verification, and medical claims processes.
• Excellent English communication skills, both written and verbal.
• Strong organizational skills, attention to detail, and ability to manage multiple responsibilities efficiently.
• Ability to work independently in a remote healthcare environment while maintaining patient confidentiality.

Responsabilités

• Handle, process, track, and follow up on prior authorization requests to ensure timely approvals and continuity of patient care.
• Answer and triage incoming patient calls, gather relevant patient information, address general inquiries, and route concerns to the appropriate healthcare personnel.
• Process prescription refill requests, coordinate with healthcare providers for approval, and monitor pending requests to ensure timely follow-up.
• Manage end-to-end medical billing processes, including claims preparation, submission, routing, payment posting, claim status monitoring, and follow-ups on outstanding or denied claims.
• Verify patient insurance eligibility, benefits, and coverage manually when insurance information or package selections in Athena EHR require correction.
• Assist with overflow patient calls during high-volume periods while maintaining professional and empathetic communication.
• Maintain accurate patient records, insurance information, authorization statuses, and billing documentation in the practice's EHR system.
• Coordinate with healthcare providers, insurance representatives, pharmacies, and internal team members to resolve patient and administrative concerns.
• Ensure accuracy, confidentiality, and compliance with HIPAA regulations when handling patient information.

Connaissances

Excellent English communication

Strong organizational skills

Attention to detail

Ability to work independently

Outils

Athena EHR

Description du poste

Position type: Full-Time

Working Hours: 9:00 AM - 6:00 PM Pacific Daylight Time , Monday - Friday
Salary rate: $5-$6

Key Responsibilities:

• Handle, process, track, and follow up on prior authorization requests to ensure timely approvals and continuity of patient care.
• Answer and triage incoming patient calls, gather relevant patient information, address general inquiries, and route concerns to the appropriate healthcare personnel.
• Process prescription refill requests, coordinate with healthcare providers for approval, and monitor pending requests to ensure timely follow-up.
• Manage end-to-end medical billing processes, including claims preparation, submission, routing, payment posting, claim status monitoring, and follow-ups on outstanding or denied claims.
• Verify patient insurance eligibility, benefits, and coverage manually when insurance information or package selections in Athena EHR require correction.
• Assist with overflow patient calls during high-volume periods while maintaining professional and empathetic communication.
• Maintain accurate patient records, insurance information, authorization statuses, and billing documentation in the practice's EHR system.
• Coordinate with healthcare providers, insurance representatives, pharmacies, and internal team members to resolve patient and administrative concerns.
• Ensure accuracy, confidentiality, and compliance with HIPAA regulations when handling patient information.

Job Title: Prior Authorization & Billing Specialist

Position type: Full-Time

Working Hours: 9:00 AM - 6:00 PM Pacific Daylight Time , Monday - Friday
Salary rate: $5-$6

Key Responsibilities:

• Handle, process, track, and follow up on prior authorization requests to ensure timely approvals and continuity of patient care.
• Answer and triage incoming patient calls, gather relevant patient information, address general inquiries, and route concerns to the appropriate healthcare personnel.
• Process prescription refill requests, coordinate with healthcare providers for approval, and monitor pending requests to ensure timely follow-up.
• Manage end-to-end medical billing processes, including claims preparation, submission, routing, payment posting, claim status monitoring, and follow-ups on outstanding or denied claims.
• Verify patient insurance eligibility, benefits, and coverage manually when insurance information or package selections in Athena EHR require correction.
• Assist with overflow patient calls during high-volume periods while maintaining professional and empathetic communication.
• Maintain accurate patient records, insurance information, authorization statuses, and billing documentation in the practice's EHR system.
• Coordinate with healthcare providers, insurance representatives, pharmacies, and internal team members to resolve patient and administrative concerns.
• Ensure accuracy, confidentiality, and compliance with HIPAA regulations when handling patient information.

Requirements

• At least 1 year of experience in medical virtual assistance, healthcare administration, medical billing, prior authorization, or a similar healthcare-related role.
• Strong understanding of medical administrative workflows, with willingness to undergo training for practice-specific processes.
• Experience handling patient calls, triage, intake, and patient coordination.
• Knowledge of prescription refill workflows, insurance eligibility verification, and medical claims processes.
• Excellent English communication skills, both written and verbal.
• Strong organizational skills, attention to detail, and ability to manage multiple responsibilities efficiently.
• Ability to work independently in a remote healthcare environment while maintaining patient confidentiality.

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.