Remote Prior Authorization Specialist – Insurance

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

Job summary

GoLean Health is seeking an experienced Medical Virtual Assistant to support a busy U.S. medical practice from the Philippines.

The role focuses on medication prior authorization, insurance coordination, and patient communication, with hands-on experience using Athenahealth and CoverMyMeds. The position requires managing time-sensitive requests, maintaining accurate clinical documentation, and ensuring HIPAA-compliant workflows.

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.
• Working knowledge of U.S. health insurance processes, including Medicare, Medicare Advantage, HMO authorization requirements.
• Experience handling inbound/outbound calls with U.S. patients, insurance representatives, pharmacies, and medical offices.

Responsibilities

• 1) Medication Prior Authorization & Insurance Coordination: initiate, submit, track, and follow up on prior authorizations using CoverMyMeds; review clinical documentation for accuracy; navigate payer requirements; manage denials or questions with providers.
• 2) Patient Communication & Care Coordination: manage patient calls, schedule appointments, coordinate referrals and medical records, and maintain clear professional communication.
• 3) EHR Documentation & Administrative Support: maintain patient records in Athenahealth, track submissions and expirations, request medical records, and ensure HIPAA compliance.

Skills

English communication

Organizational skills

Time management

Phone etiquette

Tools

Athenahealth

CoverMyMeds

Availity

Job description

GoLean Health is seeking an experienced Medical Virtual Assistant to support a busy U.S. medical practice from the Philippines.

The role focuses on medication prior authorization, insurance coordination, and patient communication, with hands-on experience using Athenahealth and CoverMyMeds. The position requires managing time-sensitive requests, maintaining accurate clinical documentation, and ensuring HIPAA-compliant workflows.