Prior Authorizations Specialist (Medical Assistant) - 1099 Contract

Fountain; Northern (KY); On-site; USD 45,000 - 65,000; Full time

Job summary

Wheel Medical Group is seeking a detail-oriented Medical Assistant focused on prior authorizations for a fully remote, 1099 contract role. You will review clinical documentation, submit authorization requests, and coordinate with clinicians and payers to ensure coverage for medications across Wheel’s telehealth platforms.

The role supports Wheel’s Clinical Operations team, emphasizing accuracy in EMR and payer systems and clear communication with clinicians, payers, and patients to keep

Qualifications

• High school diploma or equivalent; Associate’s or Bachelor’s preferred.
• Active Medical Assistant certification/registration preferred where required by state.
• 1–3 years of prior authorization, medical billing, or revenue cycle experience.
• Proficiency with EHR, practice management software, and insurance portals; multiple EMR systems a plus.
• Strong analytical and communication skills; HIPAA knowledge.

Responsibilities

• Review patient records to determine when prior authorization is required.
• Submit and track prior authorization requests with insurance carriers.
• Communicate with clinicians, payers, and patients to obtain documentation.
• Verify insurance eligibility, benefits, and coverage limitations.
• Maintain accurate records of authorization requests and outcomes in EMR.
• Resolve denials or discrepancies and escalate when needed.
• Educate patients and clinicians on prior authorization timelines.
• Monitor trends and report findings to optimize workflow.
• Collaborate with billing and patient support for coordination of care.

Skills

Detail-oriented

Relationship-oriented

Proactive learner

Effective communicator

Education

Associate’s or Bachelor’s degree in Healthcare Administration, Medical Assisting

High school diploma or equivalent

Tools

EHR

EMR systems

Practice management software

Insurance portals

Job description

Prior Authorizations Specialist (Medical Assistant) - 1099 Contract

Address Remote

About Wheel Medical Group

Wheel Medical Group is a physician owned professional corporation that serves patients across the United States; evolving the traditional care ecosystem by equipping the nation's most innovative companies with a premier platform to deliver high-quality virtual care at scale. We offer proven strategies and cutting-edge technologies to foster consumer engagement, build brand loyalty, and maximize return on investment. Wheel solutions include configurable virtual care programs, an intuitive consumer interface, and access to a nationwide network of board-certified clinicians. Discover how Wheel is transforming the future of healthcare by visiting www.wheel.com.

About the Role

As a Medical Assistant focused on Prior Authorizations on Wheel’s Clinical Operations team, you will be responsible for obtaining the approvals patients and clinicians need before medications can move forward across Wheel’s telehealth platforms. You will review clinical documentation, submit and track authorization requests, and communicate with clinicians and payers to ensure coverage requirements are met.

In this fully remote role, you will monitor requests end to end, resolve issues and denials, and maintain accurate, compliant records within the EMR. You will help facilitate timely patient care while supporting revenue cycle efficiency, and you’ll partner with billing, clinical, and patient support teams to keep authorizations moving smoothly across multiple telehealth platforms.

The ideal candidate has strong attention to detail, is comfortable navigating multiple EMR and payer systems at once, and communicates clearly with clinicians, payers, and patients. They stay current on payer requirements and telehealth regulations, and are motivated to identify and fix recurring authorization bottlenecks. They also escalate issues with prior authorizations to the RN team as needed.

This is a 100% remote, full-time (40 hours/week) position supporting a dynamic and rapidly growing virtual care organization.

Shifts: Monday - Friday 8 am- 4 pm CST or 12 pm- 8 pm CST & Saturday/ Sunday/Monday 8 am- 4 pm CST

What You’ll Do

• Review patient medical records and clinician requests within the EMR to determine when prior authorization is required.
• Submit and track prior authorization requests with insurance carriers to ensure timely approvals for medications ordered by Wheel clinicians.
• Communicate with clinicians, insurance representatives, and patients to gather necessary documentation and clarify coverage requirements.
• Verify insurance eligibility, benefits, and coverage limitations to help prevent claim denials or delays.
• Maintain accurate, timely records of authorization requests, approvals, denials, and follow-up actions within the EMR and support ticketing systems.
• Research and resolve authorization denials or discrepancies, coordinating with clinicians and payers as needed, and escalating clinical questions to licensed clinical staff.
• Educate patients and clinicians on the prior authorization process, requirements, and expected timelines.
• Monitor authorization trends and turnaround times, and report findings to the Clinical Operations team to support workflow improvements.
• Collaborate with billing, clinical, and patient support teams to ensure seamless coordination of care and reimbursement across multiple telehealth platforms.
• Stay current on payer requirements, telehealth regulations, and industry standards affecting prior authorizations.

Who You Are

• Detail-oriented: precise in completing authorization forms, documentation, and follow-up activities.
• Relationship-oriented: builds trust with clinicians, payers, and patients while balancing the needs of Wheel, our clients, and their patients.
• Quick learner: proactive self-starter who becomes fluent in Wheel’s and each client’s systems, payers, and policies.
• Solution-focused communicator: clear, respectful, and effective across clinical, billing, and patient-facing conversations.

Qualifications

• High school diploma or equivalent required; Associate’s or Bachelor’s degree in Healthcare Administration, Medical Assisting, or a related field preferred
• Active Medical Assistant certification/registration where required by state (e.g., CMA, RMA, or state-recognized equivalent) preferred
• 1–3 years of experience in prior authorization, medical billing, or revenue cycle operations
• Proficiency with electronic health records (EHR), practice management software, and insurance portals; experience with multiple EMR systems a plus
• Strong analytical skills and ability to review patient and insurance information accurately and efficiently
• Strong verbal and written communication skills for interacting with clinicians, payers, and patients
• Problem-solving ability to resolve authorization issues and denials effectively
• Working knowledge of HIPAA, insurance policies, and payer-specific authorization requirements