Prior Authorizations & Clinical Intake Virtual Assistant

This is a remote position.

Rockstar is hiring a full-time Prior Authorizations & Clinical Intake Virtual Assistant on behalf of our client, a home medical equipment and supply provider.

This role specializes in prior authorizations, clinical intake, and medical records processing. The ideal candidate has experience reviewing patient documentation and is knowledgeable about identifying required clinical records, checking documentation completeness, and ensuring all necessary information is available before an order or authorization can be processed.
About the Client

Our client is a growing home medical equipment (DME) provider, delivering products like home oxygen, CPAP/BIPAP equipment, wheelchairs, hospital beds, and other durable medical equipment directly to patients' homes. As an accredited Medicare provider and licensed Medicaid services provider that also works with private insurance, they help patients get the equipment they need without the runaround.

Their team works closely with doctors' offices to secure proper orders and handle the insurance paperwork, so most patients receive their equipment with no upfront cost. What sets them apart is genuine heart: patients aren't treated like transactions, they're treated like family, and that family keeps growing.
Key Responsibilities

Clinical Documentation & Chart Review

- Review patient charts and medical records for completeness

- Handle clinical intake and verify required documentation

- Identify missing or incomplete clinical information

- Ensure CMNs, clinical notes, and supporting documents meet payer requirements

- Maintain accurate and organized patient records

Prior Authorizations & Insurance

- Verify patient insurance eligibility and coverage prior to order fulfillment

- Submit prior authorization requests to insurance payers and track them through to approval

- Follow up proactively on pending or delayed authorizations to avoid delays in patient care

- Stay current on payer-specific documentation requirements, including Medicare and Medicaid guidelines for durable medical equipment

Communication & Coordination

- Communicate with physician offices to request missing signatures, notes, or supporting documentation

- Coordinate with the sales and delivery team to ensure orders are ready to move forward once documentation is complete

- Escalate documentation or authorization issues that require physician or payer intervention

Administrative Support
- Enter and update patient and order information accurately within Brightree

Tools & Systems

- Brightree

- Parachute Health

- Insurance Portals

Requirements

- Prior experience in DME (durable medical equipment), with strong hands-on skills in Medicaid and commercial insurance authorization processing

- Brightree and Parachute experience preferred

- Experience reviewing patient documentation and clinical records for completeness

- Knowledge of prior authorization requirements and payer documentation standards, particularly Medicaid

- Strong attention to detail with the ability to identify missing or incomplete information

- Highly organized with strong recordkeeping habits

- Comfortable working independently within a remote healthcare setting

Benefits

- Competitive salary commensurate with experience.

- Opportunities for professional development and growth.

- Work in a dynamic and supportive team environment.

- Make a meaningful impact by helping to build and strengthen families across the Globe

Originally posted on Himalayas