Remote Prior Authorization Specialist (Medical Assistant)

Fountain; Northern (KY); Hybrid; 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

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