Medical Virtual Assistant with Athena Health and Prior Authorization Expertise

Role Overview

We are seeking a skilled Medical Virtual Assistant experienced with Athena Health EMR and Prior Authorization processes within a primary care environment. This part-time remote position requires a detail-focused healthcare professional adept at managing administrative tasks and supporting patient care in a dynamic, fast-paced setting.

Work Schedule and Compensation

• Part-time role, working Monday to Thursday.
• Hours scheduled between 8:00 AM and 5:00 PM Central Time (CST).
• 1-hour unpaid lunch break daily from 12:00 PM to 1:00 PM.
• Compensation ranges from $5.00 to $6.00 USD per hour based on experience.

Primary Responsibilities

• Execute Prior Authorization requests for medications, diagnostic services, imaging, procedures, and specialty care, adhering to insurance payer portals and guidelines.
• Oversee Remote Patient Monitoring workflows by tracking patient data, documenting updates, escalating abnormal results, and liaising with providers as necessary.
• Manage patient referrals ensuring accuracy in documentation, compliance with insurance requirements, and timely communication with specialists and patients.

Additional Duties

• Coordinate with laboratories to obtain pending lab results and document them accurately in Athena Health EMR.
• Conduct insurance eligibility and benefits verification across a variety of commercial and government plans.
• Generate reports from Athena Health EMR to assist clinical and administrative processes.
• Precisely document all patient interactions, authorizations, referrals, and insurance communications within the EMR system.
• Provide phone support responding to patient queries during intervals between Prior Authorization tasks.
• Collaborate with healthcare providers, pharmacies, labs, and insurance entities to facilitate prompt patient care.
• Maintain strict HIPAA compliance and ensure patient confidentiality at all times.
• Assist with general administrative and front-office responsibilities as assigned.

Required Qualifications

• Proven experience with Prior Authorization processing (mandatory).
• Practical expertise using Athena Health EMR with no training provided.
• Previous work experience in a Primary Care clinic setting.
• Sound knowledge of medical terminology, healthcare workflow, and clinical documentation.
• Experience verifying insurance eligibility and benefits for Medicare, Medicaid, Humana, UnitedHealthcare, Anthem Blue Cross, commercial plans, CoverMyMeds, and Availity platforms.
• Familiarity with Remote Patient Monitoring (RPM) programs.
• Excellent organizational abilities and attention to detail.
• Strong multitasking, problem-solving, and time management skills.
• Fluent English communication skills, both written and oral.
• Capability to work independently remotely while maintaining productivity and accuracy.

Preferred Qualifications

• Registered Nurse (RN) background highly preferred.
• Prior clinical experience in primary care.
• Knowledge of Chronic Care Management workflows.
• Experience coordinating referrals and managing patient care follow-ups.

Technology and Tools

• Athena Health EMR (required)
• CoverMyMeds and Availity
• Athena Chat, Slack, Salesforce, WhatsApp, Skype
• Zoom Meetings, Google Meet, email, and phone systems

Top Priorities

• Prior Authorization processing (highest priority and non-negotiable)
• Remote Patient Monitoring (RPM)
• Referral processing

Basic and Technical Requirements

• Clear and professional English communication skills.
• Relevant prior work experience.
• NBI or Local Police Clearance must be provided before onboarding.
• Availability to participate in video meetings with camera enabled when required.
• Reliable laptop or desktop computer.
• Stable high-speed internet connection with a minimum speed of 25 Mbps.
• Noise-canceling headset and functioning webcam for virtual meetings.
• A quiet, professional workspace.

Additional Information - Contractor Benefits

• Access to dedicated HR and contractor support for guidance and client communications.
• Optional premium VPN license for enhanced security during client tasks.
• Provided HIPAA compliance and cybersecurity training with certification.
• Access to proprietary performance training to improve communication, productivity, and client management skills.
• Possibility to observe client-approved U.S. holidays and receive paid or unpaid time off as permitted by the client.
• Availability of tools, templates, workflow guides, and SOPs for optimal performance.
• Optional performance-based incentives including bonuses or additional hours depending on client discretion.