Medical Virtual Assistant (Claims Management, Prior Authorization & Referrals)

Job Title: Medical Virtual Assistant (Claims Management, Prior Authorization & Referrals)

Position type: Part-Time

Work hours: Between 9:00 AM – 5:00 PM EDT

Work days: Monday to Friday

Salary: $5.00 – $6.00 per hour (depending on experience)

Job code: DD-KaydiumTS

Workplace: Remote

Preferred Candidate Location: Philippines

Scope of Work/Responsibilities

We are seeking a proactive and detail-oriented Medical Virtual Assistant to support a growing therapy practice. This role is ideal for someone with healthcare administrative experience who can independently manage referrals, prior authorizations, claims follow-up, scheduling, and client communication while maintaining HIPAA compliance.

We are looking for a results-driven professional who takes initiative, follows through on tasks, and helps ensure clients receive timely access to services.

Intake & Referral Management

• Process new client inquiries and referrals through the intake process.

• Contact prospective clients within 24–48 hours of receiving inquiries.

• Complete intake processing within 7–10 days.

• Coordinate with referral sources and maintain ongoing communication.

• Manage referrals from sources such as Psychology Today and healthcare providers.

Prior Authorization & Claims Management

• Submit and manage Medicaid prior authorizations.

• Follow up on denied claims and resolve billing issues.

• Track authorization status and ensure timely approvals.

• Communicate with insurance companies regarding claim status and requirements.

Billing Accuracy & Insurance Verification

• Verify client insurance information and benefits.

• Ensure claims are set up correctly and submitted accurately.

• Review billing information for completeness and accuracy.

• Work with commercial insurance platforms, including Blue Cross Blue Shield and other payers.

Client Communication & Scheduling

• Serve as a virtual receptionist by answering and managing inbound calls.

• Make outbound calls to prospective clients and referral sources.

• Schedule appointments and send appointment reminders.

• Assist with payment collection and account follow-up when necessary.

• Provide exceptional customer service to clients and stakeholders.

Administrative Support

• Perform data entry and maintain accurate records.

• Manage workflows and task tracking using Trello.

• Update client information within SimplePractice EHR.

• Assist with general administrative and operational support tasks.

• Work independently while meeting established performance goals.Requirements

• Experience in healthcare administration, medical virtual assistance, or a related healthcare support role.

• Experience handling prior authorizations, insurance verification, referrals, or medical claims.

• Strong phone communication and customer service skills.

• Excellent organizational skills and attention to detail.

• Ability to work independently and take initiative.

• Strong follow-up and problem-solving abilities.

• Understanding of HIPAA compliance and patient confidentiality.

• Proficiency with Google Workspace and web-based applications.

• Experience with SimplePractice EHR (preferred).

• Experience using Trello for workflow management (preferred).

• Familiarity with Google Voice (preferred).

• Experience working with Medicaid and commercial insurance plans (preferred).

• Background in appointment setting, customer service, account management, or healthcare call center environments (preferred).

Tools & Platforms Used

• SimplePractice (EHR & Scheduling)

• Trello (Workflow Management)

• Google Voice (Phone System)

• Psychology Today (Referral Management)

• Commercial Insurance Portals (Blue Cross Blue Shield and others)

Success in This Role

The ideal candidate is highly organized, responsive, and outcome-focused. We value team members who consistently follow through on tasks, maintain accuracy, and contribute to measurable results rather than simply staying busy.

Basic requirements

• Must be proficient in speaking and writing English very clearly

• Must have relevant work experience

• Be able to submit an NBI clearance and/or Local Police Clearance background check before onboarding [mandatory]

• Must be available for video meetings with your camera on (when needed)

Technical requirements

• Device: Reliable laptop or desktop computer.

• Internet: High-speed connection (minimum 25 Mbps).

• Audio: Noise-canceling headset.

• Video: Webcam for virtual meetings.

• Workspace: Quiet, professional environment.Benefits

• Dedicated HR & Contractor Support Team: Access to world-class support for questions, guidance, contract matters, and client communication.

• Premium VPN Access (Optional): A secure VPN license can be provided upon request to enhance privacy and security for client-related tasks.

• HIPAA & Cybersecurity Training + Certification (Provided): Access to our internal HIPAA compliance training, cybersecurity modules, and certification to help you confidently handle PHI for U.S. healthcare clients.

• Top 1% VA Performance Training: Access to our proprietary training on communication, client management, productivity systems, and best practices to help you become a top-performing VA and increase long-term client retention.

• Client-Approved U.S. Holidays: Contractors may take U.S. holidays off according to the client’s needs and schedule.

• Client-Approved Paid or Unpaid Time Off: Time off may be granted by your client. Paid time off is optional and only if offered by the client.

• Access to Tools & Resources: Templates, workflow guides, productivity tools, and client-specific SOP support to help you perform at your best.

• Optional Performance-Based Incentives: Some clients may offer bonuses, incentives, or increased hours based on your performance.

These are optional resources and client-approved allowances available to you as an independent contractor. Any resources, trainings, or allowances listed are optional contractor perks and not employee benefits.