Remote Medical Prior Authorization & Insurance Coordinator

Go Lean Health; Iloilo City; A distancia; PHP 440.000 - 527.000; Jornada completa

Descripción de la vacante

Go Lean Health is seeking an experienced Medical Virtual Assistant to support a busy U.S. medical practice from a remote location.

The role focuses on medication prior authorizations, insurance coordination, and patient communication, requiring hands-on use of Athenahealth and CoverMyMeds to manage submissions, approvals, and denials. Ideal candidates will navigate insurance requirements, review clinical documentation, and maintain accurate records while handling live patient calls and ensuring

Formación

• Hands-on experience using Athenahealth (Athena) is mandatory.
• Hands-on experience using CoverMyMeds for medication prior authorization is mandatory.
• Proven experience independently preparing, submitting, tracking, and following up on medication prior authorization requests.
• Previous experience supporting a U.S. healthcare practice in medical administration, insurance coordination, or clinical support.
• Working knowledge of U.S. health insurance processes, pharmacy benefits, Medicare, Medicare Advantage, and HMO authorization requirements.
• Ability to interpret clinical notes, diagnoses, ICD-10 codes, medication histories, and insurance documentation requirements accurately.
• Experience handling inbound and outbound calls with U.S. patients, insurance representatives, pharmacies, and medical offices.
• Strong spoken and written English communication skills, with clear pronunciation and professional phone etiquette.
• Excellent organizational skills, attention to detail, and the ability to manage multiple time-sensitive requests.
• Demonstrated ability to work independently, maintain accurate documentation, and follow through on unresolved cases.

Responsabilidades

• 1. Medication Prior Authorization & Insurance Coordination: Initiate, submit, track, and follow up on medication prior authorizations using CoverMyMeds.
• 2. Review authorization requirements and ensure submissions meet payer criteria.
• 3. Manage patient communications and coordinate with insurance providers and pharmacies.
• 4. Maintain records and track approvals, denials, and expirations.
• 5. Address urgent cases within 72 hours when possible.

Herramientas

Athenahealth

CoverMyMeds

Descripción del empleo

Go Lean Health is seeking an experienced Medical Virtual Assistant to support a busy U.S. medical practice from a remote location.

The role focuses on medication prior authorizations, insurance coordination, and patient communication, requiring hands-on use of Athenahealth and CoverMyMeds to manage submissions, approvals, and denials. Ideal candidates will navigate insurance requirements, review clinical documentation, and maintain accurate records while handling live patient calls and ensuring