Remote Prior Authorization & Patient Support Specialist

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

Job summary

GoLean Health seeks a Medical Virtual Assistant to support a U.S. primary care practice with prior authorization, insurance coordination, and patient communication.

This remote role requires Athenahealth and CoverMyMeds experience, strong organization, and careful documentation. You will initiate and track authorizations, verify payer requirements, manage patient interactions, and maintain accurate records.

Qualifications

• Hands-on experience using Athenahealth (Athena) is mandatory.
• Hands-on experience using CoverMyMeds for medication prior authorization is mandatory.
• Experience preparing, submitting, tracking, and following up on prior authorization requests.
• Experience supporting a U.S. healthcare practice in medical administration, insurance coordination, or clinical support.
• Working knowledge of U.S. health insurance processes, Medicare, Medicare Advantage, and HMO authorization requirements.
• Ability to interpret clinical notes, diagnoses, ICD-10 codes, medication histories, and insurance documentation requirements.
• 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.
• Backup 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 submissions.

Skills

Athenahealth

CoverMyMeds

Patient communication

Tools

Athenahealth

CoverMyMeds

Job description

GoLean Health seeks a Medical Virtual Assistant to support a U.S. primary care practice with prior authorization, insurance coordination, and patient communication.

This remote role requires Athenahealth and CoverMyMeds experience, strong organization, and careful documentation. You will initiate and track authorizations, verify payer requirements, manage patient interactions, and maintain accurate records.