Prior Authorization Specialist

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Winning Assistants LLC

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51 - 200 employees

At Winning Assistants, we help doctors, healthcare professionals, and business owners save time, cut costs, and scale their operations with highly skilled, HIPAA-compliant virtual assistants. Our VAs handle tasks like admin support, medical office management, marketing, and customer service, allowing you to focus on growth.

📋 Description

• Process and submit prior authorization requests to insurance companies. • Verify patient insurance eligibility, benefits, and coverage. • Follow up with insurance carriers regarding authorization status. • Communicate professionally with providers, clinic staff, patients, and insurance representatives via phone and email. • Maintain accurate documentation of authorization requests, approvals, denials, and outcomes. • Update patient records and EMR/EHR systems with authorization information. • Investigate and resolve authorization issues, denials, or delays. • Monitor authorization expiration dates and submit renewal requests as needed. • Prioritize and manage multiple authorization cases while meeting deadlines. • Ensure compliance with HIPAA regulations and maintain patient confidentiality.

🎯 Requirements

• At least 1 year of experience in medical prior authorizations, medical billing, insurance verification, or a related healthcare administrative role. • Experience working with EMR/EHR systems. • Hands-on experience using insurance portals such as TRICARE, UnitedHealthcare (UHC), Availity, and similar payer portals for eligibility verification, authorization requests, and claim status inquiries. • Excellent verbal and written English communication skills. • Strong organizational skills with exceptional attention to detail. • Proficient in data entry and Microsoft Office/Google Workspace. • Ability to work independently in a fast-paced remote environment. • Understanding of HIPAA regulations and patient confidentiality requirements.

🏖️ 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.