Medical Virtual Assistant | Outbound Calls, Prior Authorization & Claims Support
Medical Virtual Assistant | Outbound Calls, Prior Authorization & Claims Support
Remote | Family Medicine Clinic | 30 Hours/Week | $6/Hour
About the Role
A busy Family Medicine Clinic is looking for a highly skilled Medical Virtual Assistant with strong experience in Athena , outbound calling, prior authorization, clinical documentation, claims support, and patient communication.
This role is ideal for someone who is detail-oriented, organized, proactive, and comfortable working in a fast-paced primary care setting. The right candidate must be able to communicate clearly with patients, pharmacies, providers, and insurance representatives while maintaining accurate documentation and HIPAA-compliant communication.
Key Responsibilities
Medication & Refill Management
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Process, validate, and route prescription refill requests
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Communicate refill outcomes to patients and pharmacies
- Track and manage refill queues in Athena
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Reconcile duplicate, closed, or pending refill items between pharmacy and provider
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Identify medications that require prior authorization
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Maintain and actively use CoverMyMeds for medication-related requests
Prior Authorization & Appeals
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Submit and track prior authorizations for chronic care and weight-management medications
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Follow up on pending authorizations and proactively check approval status
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Coordinate approvals, denials, and additional information requests with providers
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Process appeals when needed and document all updates accurately in Athena
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Identify delays or issues with systems such as CoverMyMeds and Evicore
Claims Processing & Insurance Follow-Up
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Assist with basic claims processing and insurance-related follow-ups
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Review claim status through payer portals or insurance communication channels
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Follow up on denied, rejected, or pending claims as instructed
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Document claim updates, payer responses, and next steps accurately
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Route claim concerns to the appropriate billing or clinical staff when escalation is needed
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Support the team in keeping claim-related tasks organized and updated
Patient Communication
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Conduct outbound calls for appointment reminders, updates, and follow-up needs
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Relay provider instructions and clinic updates professionally
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Use HIPAA-appropriate voicemail practices when leaving messages
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Respond to patient inquiries regarding symptoms, devices, test results, or next steps
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Document patient acknowledgments, pending concerns, and follow-up requirements
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Schedule or reschedule appointments as needed
Clinical Coordination
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Upload and organize documents from external facilities
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Manage discharge summaries, imaging results, clinical notes, and lab-related documents
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Notify providers of urgent symptoms or patient requests through the appropriate channel
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Request lab results from external labs and track pending items
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Ensure clinical information is routed to the correct team member promptly
Administrative Support
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Maintain accurate inbox and outbox documentation
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Close completed tasks efficiently and correctly
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Report system access issues or workflow delays when necessary
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Route tasks to the appropriate clinical, billing, or provider team
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Keep documentation clean, updated, and easy to follow
Required Tools & Platforms
- Athena expertise is a must
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Strong experience navigating Athena task queues, documentation, charting, patient records, and clinical workflows
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CoverMyMeds experience is strongly preferred
- Google Voice experience is preferred
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Charting or clinical documentation experience is required
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Experience using payer portals or insurance verification tools is a plus
Qualifications
Required
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At least 1 year of experience as a Medical Virtual Assistant, Clinical Support VA, Medical Assistant, or similar role
- Proven hands-on experience with Athena is required
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Strong outbound calling skills and professional communication