Medical VA | Prior Authorization Specialist

Global Medical Virtual Assistants

7d•Remote

About The Position

A Medical Virtual Assistant – Prior Authorization Specialist manages the end-to-end prior authorization process for healthcare practitioners. The role serves as the primary liaison between healthcare providers, insurance companies, and patients to support timely approvals for procedures, medications, diagnostic testing, and specialist referrals. The work supports patient access to care, practice workflow, and revenue cycle efficiency. The position provides specialized back-office support and requires strict adherence to HIPAA regulations and confidentiality standards for patient data, insurance details, and communications. It is a permanent work-from-home role offered as an independent contractor. The posting states a starting rate of $800 USD monthly and notes that applicants should be open to working night shifts.

Requirements

At least 6 months to 1 year of prior authorization or healthcare BPO experience handling US healthcare accounts.
Strong familiarity with insurance portals, EMR/EHR systems, and medical terminology.
Strong time-management skills.
Strong attention to detail.
Computer savvy.
Great work attitude and willingness to go the extra mile.
Open to working night shifts.
Minimum primary computer: Intel Core i5-6000 (6th Gen or higher) or AMD Ryzen 5 or higher; 8 GB RAM; Windows 11 64-bit or macOS Ventura; USB headset with noise-cancelling feature; and a camera capable of clear video output.
Minimum backup computer option: Intel Core i5-6000 (6th Gen or higher) or AMD Ryzen 5 or higher; 8 GB RAM; Windows 11 64-bit or macOS Ventura; and a USB headset with noise-cancelling feature.
Alternatively, a UPS must power the workstation for at least 3 hours, typically with 240 Wh or higher, and accept all plugs needed for the work setup.
Minimum primary internet connection: DSL or fiber with a contracted speed of at least 100 Mbps.
Minimum backup internet connection: at least 20 Mbps via cellular connection.
Recommended primary and backup computer: Intel Core i7, i9, or Core Ultra, or AMD Ryzen 7 or higher; 16 GB RAM; Windows 11 64-bit or macOS Tahoe; a USB headset with noise-cancelling feature; and a camera capable of clear video output.
Recommended primary internet connection: DSL or fiber with a contracted speed of at least 500 Mbps.
Recommended backup internet connection: at least 20 Mbps via cellular or wired connection.

Nice To Haves

HIPAA certification.

Responsibilities

Submit, track, and follow up on prior authorization requests.
Make inbound and outbound calls to insurance companies to verify authorization requirements, check status updates, and resolve pending or denied requests.
Verify patients’ insurance coverage, benefits, and plan requirements before scheduling procedures or submitting authorizations.
Retrieve relevant medical history, clinical notes, and diagnostic reports.
Serve as the primary point of contact between medical providers, patients, and payors.
Identify reasons for authorization denials, gather missing clinical information, and prepare basic appeal packages under healthcare providers’ direction.
Provide back-office support, including data entry, email management, authorization tracking log maintenance, and record management.
Follow HIPAA regulations and maintain confidentiality of patient data, insurance details, and communications.