Healthcare Virtual Assistant - PE/CR

We are looking for experienced Healthcare Virtual Assistants to support US-based healthcare providers, clinics, and medical practices. The ideal candidate has direct experience working in the US Healthcare industry, with knowledge of healthcare scheduling, insurance verification, eligibility and benefits, prior authorizations, patient communication, and clinical administrative workflows. As a key member of a US-based healthcare practice, the Healthcare Virtual Assistant acts as a liaison between patients, healthcare providers, and insurance companies. The role requires a detail-oriented, tech-savvy professional who can navigate insurance portals and electronic health records while ensuring patients receive timely and efficient support throughout their care journey.

Insurance Verification & Eligibility 
● Verify patient eligibility and insurance benefits prior to scheduled appointments and services. 
● Review insurance plans and accurately interpret coverage, limitations, exclusions, deductibles, copays, and coinsurance.
● Determine and document estimated patient financial responsibility based on available benefits. 
● Verify coverage for medical services, procedures, consultations, diagnostics, and other healthcare services. 
● Identify coverage limitations, authorization requirements, and other insurance-related restrictions. 
● Document insurance verification results accurately within the appropriate EHR or practice management system. ● Communicate with insurance carriers to clarify eligibility, benefits, coverage, and patient responsibility when needed. 

Scheduling & Patient Communication 
●Schedule, reschedule, and confirm patient appointments.
● Manage provider calendars and appointment availability to support efficient clinic workflows.
● Conduct inbound and outbound calls with patients regarding appointments, services, follow-ups, and care needs. 
● Send appointment reminders and follow up with patients regarding missed or incomplete appointments. 
● Coordinate appointments based on provider availability, patient needs, and clinic protocols. 
● Provide professional, empathetic, and patient-centered communication throughout the scheduling process.

 Prior Authorization & Care Coordination 
● Prepare and submit prior authorization requests to insurance companies through online portals, fax, or phone. 
● Collect and organize required documentation to support authorization requests. 
● Review available clinical documentation to ensure required information is included before submission. 
● Track pending authorizations and follow up with insurance carriers. 
● Communicate authorization updates to the appropriate healthcare team. 
● Assist with appeals or additional documentation requests when required. 
● Help identify potential authorization or coverage issues before services are provided to minimize delays in patient care. 

Patient Support & Healthcare Administration 
● Assist patients with questions related to appointments, insurance, benefits, documentation, and healthcare services. 
● Coordinate follow-ups, referrals, laboratory testing, imaging, and other healthcare services when applicable. 
● Follow up with patients regarding outstanding appointments, referrals, authorizations, or other care-related requirements. 
● Maintain accurate patient information and documentation. 
● Support administrative workflows that improve patient access and clinic efficiency. 
● Escalate complex clinical, insurance, billing, or coverage questions to the appropriate team member. Documentation & Practice Operations 
● Maintain accurate patient, insurance, appointment, and authorization information. 
● Document patient and insurance interactions accurately in the appropriate EHR or practice management system. 
● Navigate insurance portals and payer websites to obtain and update patient information. 
● Maintain organized records and follow established healthcare workflows. 
● Support additional administrative and operational tasks based on the needs of the healthcare practice.

Requirements 
● Experience: Must have at least 1 year of direct experience in the US Healthcare industry, scheduling, eligibility, prior authorizations, insurance verification, etc. 
● Available to work full time on any US time zone CST, EST, PST & MST 
● Core Knowledge: Deep understanding of US insurance concepts, including PPO, HMO, EOBs, copays, and patient benefits eligibility verification, prior auth and scheduling. 
● Technical Skills: Proficiency in navigating insurance portals (e.g., Availity, Optum, Covermymeds, etc) and electronic health record/practice management systems (e.g., ECW, Tebra, Dentrix etc). 
● Competencies: Exceptional attention to detail, strong analytical skills, excellent written and verbal English communication, and the ability to work independently in a fast-paced environment.