Prior Authorization & Billing Specialist

Job Title: Prior Authorization & Billing Specialist

Position type: Full-Time

Working Hours: 9:00 AM – 6:00 PM Pacific Daylight Time , Monday - Friday
Salary rate: $5-$6

Key Responsibilities:

• Handle, process, track, and follow up on prior authorization requests to ensure timely approvals and continuity of patient care.
• Answer and triage incoming patient calls, gather relevant patient information, address general inquiries, and route concerns to the appropriate healthcare personnel.
• Process prescription refill requests, coordinate with healthcare providers for approval, and monitor pending requests to ensure timely follow-up.
• Manage end-to-end medical billing processes, including claims preparation, submission, routing, payment posting, claim status monitoring, and follow-ups on outstanding or denied claims.
• Verify patient insurance eligibility, benefits, and coverage manually when insurance information or package selections in Athena EHR require correction.
• Assist with overflow patient calls during high-volume periods while maintaining professional and empathetic communication.
• Maintain accurate patient records, insurance information, authorization statuses, and billing documentation in the practice's EHR system.
• Coordinate with healthcare providers, insurance representatives, pharmacies, and internal team members to resolve patient and administrative concerns.
• Ensure accuracy, confidentiality, and compliance with HIPAA regulations when handling patient information.

Job Title: Prior Authorization & Billing SpecialistPosition type: Full-TimeWorking Hours: 9:00 AM – 6:00 PM Pacific Daylight Time , Monday - FridaySalary rate: $5-$6Key Responsibilities:Handle, process, track, and follow up on prior authorizati...

• At least 1 year of experience in medical virtual assistance, healthcare administration, medical billing, prior authorization, or a similar healthcare-related role.
• Strong understanding of medical administrative workflows, with willingness to undergo training for practice-specific processes.
• Experience handling patient calls, triage, intake, and patient coordination.
• Knowledge of prescription refill workflows, insurance eligibility verification, and medical claims processes.
• Excellent English communication skills, both written and verbal.
• Strong organizational skills, attention to detail, and ability to manage multiple responsibilities efficiently.
• Ability to work independently in a remote healthcare environment while maintaining patient confidentiality.

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 meetings.
• Workspace: Quiet and professional work environment.