Remote Medical VA: Prior Authorization & Insurance Support

Go Lean Health; Philippines; Remote; PHP 440,000 - 527,000; Full time

Job summary

Go Lean Health is seeking an experienced Medical Virtual Assistant to support a busy U.S. primary care practice from a remote Philippines-based role.

The ideal candidate will manage medication prior authorization, insurance coordination, and patient communication using Athenahealth and CoverMyMeds, with familiarity of Availity for verification. Strong organizational skills and independent work habit are essential to handle time-sensitive submissions and live patient contact.

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

• 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.
• Handle Medicare GLP-1 Bridge requests and specialist visit authorizations for HMO and Medicare Advantage plans.
• 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.

Skills

English communication

Organization

Time management

Independent work

HIPAA compliance

Education

No degree specified

Tools

Athenahealth

CoverMyMeds

Availity

Job description

Go Lean Health is seeking an experienced Medical Virtual Assistant to support a busy U.S. primary care practice from a remote Philippines-based role.

The ideal candidate will manage medication prior authorization, insurance coordination, and patient communication using Athenahealth and CoverMyMeds, with familiarity of Availity for verification. Strong organizational skills and independent work habit are essential to handle time-sensitive submissions and live patient contact.