Medical Virtual Assistant | Outbound Calls, Prior Authorization

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

• Process, validate, and route prescription refill requests

• Communicate refill outcomes to patients and pharmacies

• Track and manage refill queues in Athena

• Reconcile duplicate, closed, or pending refill items between pharmacy and provider

• Identify medications that require prior authorization

• Maintain and actively use CoverMyMeds for medication-related requests

Prior Authorization & Appeals

• Submit and track prior authorizations for chronic care and weight-management medications

• Follow up on pending authorizations and proactively check approval status

• Coordinate approvals, denials, and additional information requests with providers

• Process appeals when needed and document all updates accurately in Athena

• Identify delays or issues with systems such as CoverMyMeds and Evicore

Claims Processing & Insurance Follow-Up

• Assist with basic claims processing and insurance-related follow-ups

• Review claim status through payer portals or insurance communication channels

• Follow up on denied, rejected, or pending claims as instructed

• Document claim updates, payer responses, and next steps accurately

• Route claim concerns to the appropriate billing or clinical staff when escalation is needed

• Support the team in keeping claim-related tasks organized and updated

Patient Communication

• Conduct outbound calls for appointment reminders, updates, and follow-up needs

• Relay provider instructions and clinic updates professionally

• Use HIPAA-appropriate voicemail practices when leaving messages

• Respond to patient inquiries regarding symptoms, devices, test results, or next steps

• Document patient acknowledgments, pending concerns, and follow-up requirements

• Schedule or reschedule appointments as needed

Clinical Coordination

• Upload and organize documents from external facilities

• Manage discharge summaries, imaging results, clinical notes, and lab-related documents

• Notify providers of urgent symptoms or patient requests through the appropriate channel

• Request lab results from external labs and track pending items

• Ensure clinical information is routed to the correct team member promptly

Administrative Support

• Maintain accurate inbox and outbox documentation

• Close completed tasks efficiently and correctly

• Report system access issues or workflow delays when necessary

• Route tasks to the appropriate clinical, billing, or provider team

• Keep documentation clean, updated, and easy to follow

Required Tools & Platforms

• Athena expertise is a must

• Strong experience navigating Athena task queues, documentation, charting, patient records, and clinical workflows

• CoverMyMeds experience is strongly preferred

• Google Voice experience is preferred

• Charting or clinical documentation experience is required

• Experience using payer portals or insurance verification tools is a plus

Qualifications

Required

• 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

• Strong outbound calling skills and professional communication

• Prior authorization experience

• Cla