Healthcare Prior Authorization & Insurance Verification Virtual Assistant

Job Title: Healthcare Prior Authorization & Insurance Verification Virtual Assistant Position Type: Full-Time Work Hours: 8:00 AM 5:00 PM CDT Work Days: Monday Thursday Salary: $5 $6 per hour (depending on experience) Job Code: KF-VCPB Workplace: Remote Preferred Candidate Location: Philippines or Latin America About the Role We are seeking an experienced Healthcare Virtual Assistant to support a busy vascular surgery practice with prior authorizations, insurance verification, referrals, patient estimates, and medical records coordination. This role requires someone who can work independently, think critically, and manage multiple time-sensitive requests while maintaining accuracy and professionalism. The ideal candidate has extensive experience working with U.S. healthcare practices and is highly skilled in authorization workflows, insurance verification, CPT coding review, and clinical documentation support. Core Responsibilities Prior Authorization Management (Top Priority) Manage prior authorizations for vascular surgery procedures Submit and track radiology authorizations (CT, MRI, MRA, CTA, Ultrasound) Monitor authorization requests and update CPT codes when procedures change Prepare and submit authorization letters and supporting documentation Communicate with insurance companies regarding approvals, denials, modifications, and status updates Manage TriWest and Veteran authorization requests Review patient charts and gather supporting clinical documentation for insurance submissions Collaborate with providers and nurses to obtain missing clinical information Insurance Verification, Referrals & Patient Estimates (Top Priority) Verify insurance eligibility and patient benefits Handle HMO referrals and referral follow-ups Review patient notes and identify appropriate CPT codes Generate patient cost estimates based on CPT codes and insurance coverage Verify copays, deductibles, and out-of-pocket expenses Assist with patient billing inquiries and insurance-related questions Medical Records & Clinical Documentation Coordination (Top Priority) Process and follow up on medical record requests Ensure imaging reports, laboratory results, and medical records are received before appointments Review clinical notes and extract relevant information for authorizations Maintain accurate documentation within the EHR/EMR system Monitor internal communications and respond to authorization-related requests in real time Additional Administrative Support Follow up on billing claims and insurance issues Manage documentation related to referrals, insurance, billing, and patient records Provide administrative support for healthcare operations and scheduling workflows Software & Systems CGM EMD (CompuGroup Medical EMD) Microsoft Teams SIP Trunk VoIP System Sangoma Digium App Key Performance Indicators (KPIs) Timely submission and approval of prior authorizations Accurate insurance verification and patient cost estimates Efficient management of referrals and authorization requests Complete and accurate documentation within the EHR Timely follow-up on insurance and medical record requests Responsiveness to urgent authorization and scheduling needs Consistent communication with providers, nurses, insurance companies, and patientsRequirements Extensive experience with prior authorizations is required Extensive experience with insurance verification and benefits verification is required Experience managing HMO referrals and authorization workflows is required Strong understanding of CPT codes and medical billing processes is required Experience working with U.S. healthcare practices is required Healthcare administrative experience is required Experience with vascular surgery, specialty care, or radiology authorizations is highly preferred Previous virtual assistant experience preferred but not required Required Skills Strong understanding of prior authorization processes Experience handling radiology authorizations (CT, MRI, MRA, CTA, Ultrasound) Ability to review clinical notes and gather supporting documentation Experience with patient estimates and insurance benefit verification Strong documentation and record management skills Proficiency with EHR/EMR systems Strong critical thinking and problem-solving abilities Excellent organizational and time management skills Ability to manage multiple authorization requests simultaneously Strong communication skills with insurance companies, providers, nurses, and patients Ability to work independently with minimal supervision Strong sense of urgency and follow-through Preferred Qualities Highly detail-oriented and accurate Proactive and resourceful Professional and dependable Comfortable in a fast-paced healthcare environment Quick learner who can adapt to new systems and workflows Takes J