Medical Virtual Assistant - Prior Authorization & Billing Support (Athena EHR)
Job Title: Medical Virtual Assistant – Prior Authorization & Billing Support (Athena EHR)
Position type: Full-time
Work Schedule: Monday to Friday 8:00 AM to 5:00 PM MDT with 30-minute unpaid meal break + two 15-minute breaks
Pay Rate: 5-6 USD per hour
Client Overview and Job Summary
Our client is a U.S.-based mobile primary and palliative care practice that brings healthcare directly to patients in their homes, assisted living communities, and other residential care settings. The practice primarily supports seniors and patients who benefit from convenient, personalized medical care.
We're looking for a dependable Prior Authorization & Medical Billing Specialist who will take ownership of prior authorization tasks while also supporting claims resolution, billing workflows, faxes and orders, and occasional patient phone inquiries.
You'll work closely with a supportive healthcare team and play an important role in keeping both patient care and administrative processes moving smoothly.
Key Responsibilities
Prior Authorizations & Billing Support
- Manage prior authorization requests from submission through follow-up and resolution.
- Track pending authorizations and follow up on approvals and denials.
- Assist with medical billing and claims-related tasks.
- Review denied claims and investigate issues such as missing authorizations, incorrect patient information, and other discrepancies.
- Help resolve outstanding claim holds and ensure issues are corrected before submission or resubmission.
- Keep documentation accurate and up to date in Athena EHR.
Patient & Administrative Support
- Manage incoming and outgoing faxes through Athena.
- Monitor and process orders and other assigned healthcare administrative tasks.
- Provide overflow phone support and assist with patient inquiries.
- Help with scheduling requests and route patients to the appropriate team member.
- Receive non-controlled medication refill requests and coordinate them with the appropriate clinical team.
- Work closely with onsite medical assistants and other team members to ensure patient needs are addressed.
- Use Spruce for patient phone communication and coordination.
Requirements
Must-Haves
- Hands-on experience with Athena EHR / athenahealth.
- Experience working in primary care.
- Experience handling prior authorizations.
- Experience with medical billing, claims processing, denied claims, or claims resolution.
- Healthcare administrative or Medical Virtual Assistant experience.
- Strong spoken and written English communication skills.
- Clear and patient phone communication.
- Strong attention to detail and follow-through.
- Ability to organize multiple tasks and work effectively with a healthcare team.
Nice to Have
- Experience with Spruce Health.
- Experience in home health, mobile primary care, palliative care, geriatric care, or other home-based healthcare settings.
- Experience supporting elderly or geriatric patients.
- Experience managing Athena faxes, orders, and claim holds
KPI
Your performance will focus on the quality, accuracy, and timely completion of your work, including:
- Prior authorizations completed and followed up on.
- Daily tasks completed.
- Orders processed through Athena.
- Incoming and outgoing Athena faxes managed.
- Patient calls handled through Spruce.
- Claims and claim holds investigated and resolved.
- Accurate documentation and consistent follow-through.
Basic Requirements
- Must speak and write English clearly and professionally.
- Must have relevant work experience.
- Must be able to provide an NBI Clearance and/or Local Police Clearance before onboarding (mandatory).
- Must be available to attend video meetings with camera on when required.
Technical Requirements
- Computer: Reliable laptop or desktop computer.
- Internet: Stable high-speed internet connection (minimum 25 Mbps).
- Audio: Noise-canceling headset.
- Video: Working webcam for virtual mee