Remote Medical Prior Auth & Insurance Specialist

GoLean Health; Makati; A distancia; PHP 440.000 - 527.000; Jornada completa

Descripción de la vacante

GoLean Health is seeking an experienced Medical Virtual Assistant to support a U.S. medical practice from a remote setting. You will handle medication prior authorizations, insurance coordination, and patient communications with a focus on accuracy and HIPAA-compliant documentation.

The role requires strong Athenahealth and CoverMyMeds experience, ability to navigate payer requirements, and seamless live patient support. Flexible scheduling and fast, reliable internet are essential.

Formación

• Hands-on experience using Athenahealth (Athena) is mandatory.
• Hands-on experience using CoverMyMeds for medication prior authorization is mandatory.
• Proven experience independently submitting, tracking, and following up on PA requests.
• Experience supporting a U.S. healthcare practice in medical administration or insurance coordination.
• Strong English communication, both spoken and written, with professional phone etiquette.
• Ability to interpret clinical notes, ICD-10 codes, medication histories, and insurance documentation requirements accurately.

Responsabilidades

• Initiate, submit, track, and follow up on medication prior authorizations using CoverMyMeds.
• Process authorizations for GLP-1 and weight-management medications, ADHD medications, hormonal treatments, and other prescriptions requiring insurance approval.
• Review clinical documentation, diagnoses, ICD-10 codes, medication histories, and payer requirements to ensure accurate submissions.
• Navigate insurance portals, including Availity, to verify requirements and obtain authorization approvals.
• Monitor pending requests, coordinate missing documentation, and elevate denials or clinical questions to the appropriate provider.
• Initiate new authorization requests ideally within 24 hours of patient visits and proactively manage outstanding cases.

Conocimientos

Athenahealth

CoverMyMeds

Insurance coordination

Medical administration

English communication

Herramientas

Athenahealth

CoverMyMeds

Availity

Descripción del empleo

GoLean Health is seeking an experienced Medical Virtual Assistant to support a U.S. medical practice from a remote setting. You will handle medication prior authorizations, insurance coordination, and patient communications with a focus on accuracy and HIPAA-compliant documentation.

The role requires strong Athenahealth and CoverMyMeds experience, ability to navigate payer requirements, and seamless live patient support. Flexible scheduling and fast, reliable internet are essential.