Remote Medical VA: Prior Authorization & Insurance Support

GoLean Health; Pasig; Remote; PHP 440,000 - 528,000; Full time

Job summary

GoLean Health is seeking a Medical Virtual Assistant with solid experience in medication prior authorization, insurance coordination, and patient communication to support a U.S. medical practice.

The role manages prior authorizations, reviews documentation, and handles patient and insurer interactions with Athenahealth and CoverMyMeds. Ideal candidates balance back-office duties with live patient calls, navigate Medicare and HMO rules, and maintain HIPAA-compliant records.

Qualifications

• 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.
• Back up power and internet are needed.

Responsibilities

• 1. Medication Prior Authorization & Insurance Coordination: Initiate, submit, track, and follow up on medication prior authorizations using CoverMyMeds.
• 2. Patient Communication & Care Coordination: Manage inbound patient calls, voicemails, and outbound communications with patients, pharmacies, insurance companies, and healthcare providers.
• 3. EHR Documentation, Case Management & Administrative Support: Maintain accurate patient records, authorization updates, and follow-up documentation using Athenahealth (Athena).
• 4. Track authorization submissions, approvals, denials, expiration dates, and pending actions.
• 5. Request and process medical records from providers and labs.
• 6. Take ownership of assigned cases and resolve within 72 hours where possible.

Skills

Athenahealth

CoverMyMeds

PA submission

English skills

Tools

Availity

Job description

GoLean Health is seeking a Medical Virtual Assistant with solid experience in medication prior authorization, insurance coordination, and patient communication to support a U.S. medical practice.

The role manages prior authorizations, reviews documentation, and handles patient and insurer interactions with Athenahealth and CoverMyMeds. Ideal candidates balance back-office duties with live patient calls, navigate Medicare and HMO rules, and maintain HIPAA-compliant records.