Winning Assistants LLC

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

Winning Assistants LLC  •  Republic of the Philippines (Remote)  •  8 hours ago
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Job Description

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.

Winning Assistants LLC

About Winning Assistants LLC

At Winning Assistants, we help doctors, healthcare professionals, and business owners save time, cut costs, and scale their operations with highly skilled, HIPAA-compliant virtual assistants. Our VAs handle tasks like admin support, medical office management, marketing, and customer service, allowing you to focus on growth.

Industry
HR & Recruiting
Company Size
51-200 employees
Headquarters
Irvine, California
Year Founded
Unknown
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