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    • Retrieving relevant medical history, clinical notes, and diagnostic reports.
    • Strong familiarity with insurance portals, EMR/EHR systems, and medical terminology…
    • View all Global Medical Virtual Assistants jobs - Quezon City jobs - Prior Authorization Specialist jobs in Quezon City
    • Salary Search: Medical VA | Prior Authorization Specialist salaries in Quezon City
    • Research and correct rejected claims and post payments.
    • Resubmissions of claims as required with supporting documentation as needed.
    • Everyday responsibilities include processing data from medical coders, ensuring claims get processed and paid, verifying insurance coverage, reviewing denied…
    • Understanding of ICD-10-CM, CPT, HCPCS, and medical necessity guidelines.
    • As a Revenue Cycle Denials Specialist you are responsible for identifying,…
    • Experience in medical billing/AR collections.
    • Handle documents, emails, and calls related to account processes.
    • Familiarity with UB Claims and UB04 forms.
    • A medical virtual assistant works closely with medical professionals or health insurance companies to ensure that the best interests of the healthcare provider,…
    • This function is responsible for Collections for Healthcare unpaid claims.
    • This positions in this function interact with customers gathering support data to…
    • Join our team as a Medical Account Chat Representative and assist customers with medical-related inquiries, healthcare services, and account concerns through…
    • Familiarity with prior authorizations and medical necessity documentation for DME.
    • Some experience in US medical billing, claims, or revenue cycle (any…
    • Experience in medical billing/AR collections.
    • Handle documents, emails, and calls related to account processes.
    • Familiarity with UB Claims and UB04 forms.
    • Experienced on medical billing/ AR Collections.
    • Ability to identify and correct medical billing errors.
    • Proficient in processing health and medical insurance…
    • Manage Accounts Receivable (AR) and follow up on unpaid or denied claims.
    • Perform outbound calls to insurance companies for claim status and resolution.
    • A medical virtual assistant works closely with medical professionals or health insurance companies to ensure that the best interests of the healthcare provider,…
    • We are looking for Customer Service Agents to support healthcare claims operations by handling customer and provider inquiries through inbound and outbound…
    • Experience in medical billing/AR collections.
    • Handle documents, emails, and calls related to account processes.
    • Familiarity with UB Claims and UB04 forms.

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Job Post Details

Medical VA | Prior Authorization Specialist
Global Medical Virtual Assistants
Quezon City
•
Remote
PHP 590,000 - PHP 600,000 a year
Full-time
Apply now

Job details

PHP 590,000 - PHP 600,000 a year
Full-time
Remote in Quezon City

Full job description

A Medical Virtual Assistant – Prior Authorization Specialist manages the end-to-end prior authorization process for our healthcare practitioners. You will serve as the primary liaison between healthcare providers, insurance companies, and patients to ensure timely approvals for procedures, medications, diagnostic testing, and specialist referrals. Your work will directly impact patient care access, practice workflow, and revenue cycle efficiency.

TASKS:

  • Submitting, tracking, and following up on prior authorization requests.
  • Managing inbound and outbound calls with healthcare insurance companies to verify authorization requirements, check status updates, and resolve pending or denied requests.
  • Verifying patient healthcare insurance coverage, benefits, and specific plan requirements prior to scheduling procedures or submitting authorizations.
  • Retrieving relevant medical history, clinical notes, and diagnostic reports.
  • Acting as the primary point of contact between medical providers, patients, and payors.
  • Identifying reasons for authorization denials, gathering missing clinical information, and preparing basic appeal packages under the direction of healthcare providers.
  • Providing specialized back-office support, including data entry, email management, authorization tracking log maintenance, and record management.
  • Strictly adhering to HIPAA regulations and maintaining confidentiality across all patient data, insurance details, and communications.

Requirements


QUALIFICATIONS:

  • Minimum of 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.
  • HIPAA Certification is a plus
  • Excellent time management
  • Strong attention to detail
  • Computer savvy
  • Great work attitude and willingness to go the extra mile
  • Open to working night shifts

MINIMUM SYSTEM REQUIREMENTS:

  • PRIMARY SYSTEM
    • Computer Processor: Intel Core i5-6000 (6th Gen or higher) or AMD Ryzen 5 2000 series or higher
    • Computer Memory/RAM: 8.00 GB
    • Computer Operating System: At least Windows 11 64-bit or macOS Sonoma (14)
    • Headset: Any USB-type headset with noise-cancelling feature
    • Camera: Capable of a clear and crisp video output
  • BACK-UP SYSTEM
    • OPTION 1 (BACKUP SYSTEM):
      • Computer Processor: Intel Core i5-6000 (6th Gen or higher) or AMD Ryzen 5 or higher
      • Computer Memory/RAM: 8.00 GB
      • Computer Operating System: At least Windows 11 64-bit or macOS Sonoma (14)
      • Headset: Any USB-type headset with noise-cancelling feature (Optional)
    • OPTION 2 (POWER SUPPLY - UPS):
      • Must be capable of powering your work station for at least 3 hours
      • Typically a device with 240Wh or higher will be sufficient
      • Must be capable of accepting all the plugs required to maintain the primary device and work environment (device, monitor, modem, cell phone if using as internet backup)
  • PRIMARY INTERNET CONNECTION
    • DSL / Fiber Connection - Minimum of 100mb/s contracted
  • BACK-UP INTERNET CONNECTION
    • Minimum of 20mb/s (Cell)

RECOMMENDED SYSTEM REQUIREMENTS

  • PRIMARY SYSTEM
    • Computer Processor: Intel Core i7 and i9 Core or Core Ultra or AMD Ryzen 7 3000 series or higher
    • Computer Memory/RAM: 16.00 GB
    • Computer Operating System: At least Windows 11 64-bit or macOS Tahoe
    • Headset: Any USB-type headset with noise-cancelling feature
    • Camera: Capable of a clear and crisp video output
  • BACK-UP SYSTEM
    • OPTION 1 (BACKUP SYSTEM):
      • Computer Processor: Intel Core i7 and i9 Core or Core Ultra or AMD Ryzen 7 or higher
      • Computer Memory/RAM: 16.00 GB
      • Computer Operating System: At least Windows 11 64-bit or macOS Tahoe
      • Headset: Any USB-type headset with noise-cancelling feature
      • Camera: Capable of a clear and crisp video output
    • OPTION 2 (POWER SUPPLY - UPS):
      • Must be capable of powering your work station for at least 3 hours
      • Typically a device with 240Wh or higher will be sufficient
      • Must be capable of accepting all the plugs required to maintain the primary device and work environment (device, monitor, modem, cell phone if using as internet backup)
  • PRIMARY INTERNET CONNECTION
      • DSL / Fiber Connection - Minimum of 500mb/s contracted
  • BACK-UP INTERNET CONNECTION
      • Minimum of 20mb/s (Cell or wired)

Benefits


RATE AND REWARDS:

  • Starting rate is $800 (USD) monthly
  • Employment Type: Independent Contractor
  • Free Training
  • Paid Time Offs
  • HMO Coverage
  • Optical Rewards
  • Performance-Based Increase
  • Permanent Work From Home
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