Prior Authorization – Billing Specialist
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Job Description
Remote Prior Authorization & Billing Specialist managing authorizations, patient calls, refills, and medical billing. Supporting U.S. healthcare operations from the Philippines while maintaining HIPAA compliance.
Responsibilities:
- Handle, process, track, and follow up on prior authorization requests
- Answer and triage incoming patient calls
- Gather patient information, address general inquiries, and route concerns to appropriate healthcare personnel
- Process prescription refill requests and coordinate with healthcare providers for approval
- Monitor pending prescription requests for timely follow-up
- Manage end-to-end medical billing, including claims preparation, submission, routing, payment posting, status monitoring, and follow-ups on outstanding or denied claims
- Verify patient insurance eligibility, benefits, and coverage manually when insurance information or package selections in Athena EHR require correction
- Assist with overflow patient calls during high-volume periods
- Maintain accurate patient records, insurance information, authorization statuses, and billing documentation in the practice’s EHR system
- Coordinate with healthcare providers, insurance representatives, pharmacies, and internal team members
- Ensure accuracy, confidentiality, and HIPAA compliance when handling patient information
Requirements:
- At least 1 year of experience in medical virtual assistance, healthcare administration, medical billing, prior authorization, or a similar healthcare-related role
- Strong understanding of medical administrative workflows
- Willingness to undergo training for practice-specific processes
- Experience handling patient calls, triage, intake, and patient coordination
- Knowledge of prescription refill workflows, insurance eligibility verification, and medical claims processes
- Excellent English communication skills, both written and verbal
- Strong organizational skills and attention to detail
- Ability to manage multiple responsibilities efficiently
- Ability to work independently in a remote healthcare environment while maintaining patient confidentiality
- Must speak and write English clearly and professionally
- Must have relevant work experience
- Must be able to provide an NBI Clearance and/or Local Police Clearance before onboarding
- Must be available to attend video meetings with camera on when required
- Reliable laptop or desktop computer
- Stable high-speed internet connection (minimum 25 Mbps)
- Noise-canceling headset
- Working webcam for virtual meetings
- Quiet and professional work environment
Benefits:
- Dedicated HR & Contractor Support Team
- Premium VPN Access (Optional)
- HIPAA & Cybersecurity Training + Certification (Provided)
- Top 1% VA Performance Training
- Client-Approved U.S. Holidays
- Client-Approved Paid or Unpaid Time Off
- Access to Tools & Resources
- Optional Performance-Based Incentives
- Bonuses, incentives, or increased hours may be offered based on performance
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