Surgical Prior Authorization

2 weeks ago

Work from Home, Philippines The Vein Clinic of Dallas Full time ₱288,000 - ₱432,000 per year

About Us

The Vein Clinic of Dallas is a leading US-based medical practice specializing in varicose and spider vein treatment. We are committed to delivering excellent, physician-led care and are looking for an experienced Virtual Assistant to join our team.

Position Overview

We are seeking a Virtual Assistant with experience in medical insurance processes, especially prior authorizations and benefits verification. The ideal candidate has worked in a physician group practice, understands US insurance workflows, and can work independently while coordinating daily with our office manager and team.

Key Responsibilities

Prior Authorization & Pre-Determinations

  • Submit, track, and follow up on insurance pre-authorizations for surgical procedures.
  • Communicate with insurance companies via portals, phone, or fax to resolve authorization issues.
  • Manage denials, including resubmissions and appeals.
  • Keep accurate records in EMR, including tracking authorization approvals and expirations.

Benefits & Eligibility

  • Verify patient insurance coverage (deductibles, copays, coinsurance, OOP maximums).
  • Document and clearly communicate benefits information for staff and patients.

Denial & Claims Support

  • Assist with insurance denial management and appeals paperwork.
  • Support billing team with claim denial follow-ups as needed.
  • Escalate complex or unusual cases appropriately.

Team & Workflow

  • Report directly to the Office Manager.
  • Work independently to complete and clear your daily list of authorizations, benefit checks, and follow-ups.
  • Maintain consistent communication with the team on task status.

Qualifications

  • 2+ years of experience with medical prior authorizations in a physician or specialty practice (surgical experience strongly preferred).
  • 2+ years of experience in insurance verification/eligibility checks.
  • Familiar with CPT, ICD-10, EOBs, and US insurance requirements.
  • Strong communication skills for working with insurance companies.
  • Experience with EMR systems (eClinicalWorks v11+ preferred) and payer portals (e.g., Availity, ).
  • Highly organized, detail-oriented, and able to manage daily task lists independently.

Preferred Skills

  • Prior authorization experience in surgical specialties (vascular, cardiology, orthopedics, GI, etc.).
  • Familiarity with US payer policies, PPO/HMO, and Medicare Advantage.
  • Knowledge of vein care, vascular, or interventional radiology (a plus but not required).

Technical Requirements

  • Windows computer (8GB RAM minimum, SSD).
  • Dual monitors.
  • Noise-cancelling headset.
  • VPN setup.
  • Reliable high-speed internet.

Job Types: Full-time, Part-time

Pay: Php35,000.00 per month

Expected hours: 40 per week

Application Question(s):

  • Have you done surgical prior authorizations (not pharmacy)? If yes, list specialty.
  • What is your typing speed - words per minute?
  • How comfortable are you with insurance portals -eg. Availity, UHC portal etc.? from 0-10? (10 being extremely proficient with many years of experience)
  • How good are you with Microsoft Word and Excel, from 0-10? (10 being extremely proficient with many years of experience)
  • How do you rank your multitasking skills from 0-10? (10 being extremely proficient)
  • How computer savvy are you from 0-10? (10 being extremely proficient)
  • How good are you in speaking to insurance companies regarding insurance claims matters from 0-10? (10 being extremely proficient with many years of experience)
  • Do you have experience working directly with a US based medical/surgical clinic? If so, how many years?

Work Location: Remote

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