Role Description We are seeking an experienced Healthcare Virtual Assistant to support a busy vascular surgery practice with prior authorizations, insurance verification, referrals, patient estimates, and medical records coordination. This role requires someone who can work independently, think critically, and manage multiple time-sensitive requests while maintaining accuracy and professionalism. The ideal candidate has extensive experience working with U.S. healthcare practices and is highly skilled in: - Authorization workflows - Insurance verification - CPT coding review - Clinical documentation support Core Responsibilities - Prior Authorization Management (Top Priority) - Manage prior authorizations for vascular surgery procedures - Submit and track radiology authorizations (CT, MRI, MRA, CTA, Ultrasound) - Monitor authorization requests and update CPT codes when procedures change - Prepare and submit authorization letters and supporting documentation - Communicate with insurance companies regarding approvals, denials, modifications, and status updates - Manage TriWest and Veteran authorization requests - Review patient charts and gather supporting clinical documentation for insurance submissions - Collaborate with providers and nurses to obtain missing clinical information - Insurance Verification, Referrals & Patient Estimates (Top Priority) - Verify insurance eligibility and patient benefits - Handle HMO referrals and referral follow-ups - Review patient notes and identify appropriate CPT codes - Generate patient cost estimates based on CPT codes and insurance coverage - Verify copays, deductibles, and out-of-pocket expenses - Assist with patient billing inquiries and insurance-related questions - Medical Records & Clinical Documentation Coordination (Top Priority) - Process and follow up on medical record requests - Ensure imaging reports, laboratory results, and medical records are received before appointments - Review clinical notes and extract relevant information for authorizations - Maintain accurate documentation within the EHR/EMR system - Monitor internal communications and respond to authorization-related requests in real time - Additional Administrative Support - Follow up on billing claims and insurance issues - Manage documentation related to referrals, insurance, billing, and patient records - Provide administrative support for healthcare operations and scheduling workflows Software & Systems - CGM EMD (CompuGroup Medical EMD) - Microsoft Teams - SIP Trunk VoIP System - Sangoma Digium App Key Performance Indicators (KPIs) - Timely submission and approval of prior authorizations - Accurate insurance verification and patient cost estimates - Efficient management of referrals and authorization requests - Complete and accurate documentation within the EHR - Timely follow-up on insurance and medical record requests - Responsiveness to urgent authorization and scheduling needs - Consistent communication with providers, nurses, insurance companies, and patients Requirements - Extensive experience with prior authorizations is required - Extensive experience with insurance verification and benefits verification is required - Experience managing HMO referrals and authorization workflows is required - Strong understanding of CPT codes and medical billing processes is required - Experience working with U.S. healthcare practices is required - Healthcare administrative experience is required - Experience with vascular surgery, specialty care, or radiology authorizations is highly preferred - Previous virtual assistant experience preferred but not required Required Skills - Strong understanding of prior authorization processes - Experience handling radiology authorizations (CT, MRI, MRA, CTA, Ultrasound) - Ability to review clinical notes and gather supporting documentation - Experience with patient estimates and insurance benefit verification - Strong documentation and record management skills - Proficiency with EHR/EMR systems - Strong critical thinking and problem-solving abilities - Excellent organizational and time management skills - Ability to manage multiple authorization requests simultaneously - Strong communication skills with insurance companies, providers, nurses, and patients - Ability to work independently with minimal supervision - Strong sense of urgency and follow-through Preferred Qualities - Highly detail-oriented and accurate - Proactive and resourceful - Professional and dependable - Comfortable in a fast-paced healthcare environment - Quick learner who can adapt to new systems and workflows - Takes ownership of tasks and follows through to resolution Deal Breakers - No prior authorization experience - No insurance verification experience - No experience with HMO referrals - Weak understanding of CPT codes and medical billing processes - No experience working with U.S. healthcare practices - Poor attention to detail - Inability to manage multiple requests simultaneously - Lack of responsiveness during work hours - Failure to comply with HIPAA, security, antivirus, or VPN requirements Basic Requirements - Must be proficient in speaking and writing English very clearly - Must have relevant work experience - Be able to submit an NBI clearance and/or Local Police Clearance background check before onboarding [mandatory] - Must be available for video meetings with your camera on (when needed) Technical Requirements - Device: Reliable laptop or desktop computer. - Internet: High-speed connection (minimum 25 Mbps). - Audio: Noise-canceling headset. - Video: Webcam for virtual meetings. - Workspace: Quiet, professional environment. Benefits - Dedicated HR & Contractor Support Team: Access to world-class support for questions, guidance, contract matters, and client communication. - Premium VPN Access (Optional): A secure VPN license can be provided upon request to enhance privacy and security for client-related tasks. - HIPAA & Cybersecurity Training + Certification (Provided): Access to our internal HIPAA compliance training, cybersecurity modules, and certification to help you confidently handle PHI for U.S. healthcare clients. - Top 1% VA Performance Training: Access to our proprietary training on communication, client management, productivity systems, and best practices to help you become a top-performing VA and increase long-term client retention. - Client-Approved U.S. Holidays: Contractors may take U.S. holidays off according to the client’s needs and schedule. - Client-Approved Paid or Unpaid Time Off: Time off may be granted by your client. Paid time off is optional and only if offered by the client. - Access to Tools & Resources: Templates, workflow guides, productivity tools, and client-specific SOP support to help you perform at your best. - Optional Performance-Based Incentives: Some clients may offer bonuses, incentives, or increased hours based on your performance.