# Medical VA - Prior Authorization (meds) & Patient Coordinator (Pediatrics)

> Staffing for Doctors · Philippines (Remote) · — · Posted 2026-08-17

**Workplace:** remote

## Description

### **Position Overview**

We are seeking a detail-oriented, highly proactive **Healthcare Virtual Assistant (HVA)** specializing in **Medication Prior Authorizations (PAs)** and high-touch patient care coordination. In this role, you will independently manage end-to-end medication PAs—from initial submission through appeals and approvals—while serving as a compassionate, clear communicator for our U.S. patients and families.

The ideal candidate combines strong clinical administrative expertise (handling payer portals, denials, and appeals) with exceptional spoken English and a warm phone presence. Experience in **pediatrics** is a significant plus.

## Requirements

### **Key Responsibilities**

### **1\. Medication Prior Authorization & Appeals Management**

-   **End-to-End PA Ownership:** Independently initiate, track, and manage active medication prior authorization cases from pre-submission to final decision.
-   **Denial & Appeal Handling:** Review insurance denials, gather required clinical documentation/chart notes from EHR, and draft/submit formal appeal letters and peer-to-peer review prep.
-   **Payer Communication:** Proactively contact U.S. commercial, Medicare, and Medicaid payers to track status, clarify clinical criteria, and resolve authorization bottlenecks.

### **2\. Patient Coordination & Front-Desk Communication**

-   **Direct Patient Engagement:** Serve as a primary point of contact for U.S. patients or parents via phone, SMS, and email regarding medication status, insurance updates, and appointment scheduling.
-   **Empathetic De-escalation:** Explain complex insurance processes, coverage delays, and out-of-pocket estimates to patients with clarity, warmth, and high listening comprehension.
-   **Insurance Verification:** Verify medical and pharmacy benefits, copays, deductibles, and formulary coverage prior to order queuing.

### **3\. Workflow Execution & Administrative Accountability**

-   **EHR & Portal Hygiene:** Maintain pristine documentation, logs, and status updates across practice management systems, payer portals (CoverMyMeds, Availity, NaviNet), and communication channels.
-   **Escalation Judgment:** Apply strong problem-solving skills to identify workflow roadblocks early and escalate complex clinical issues to providers only when necessary.
-   **Independent Execution:** Quickly adapt to practice-specific protocols and operate autonomously following initial onboarding and training.

### **Qualifications & Key Attributes**

-   **Prior Authorization Expertise:** Minimum **2+ years** of hands-on experience specifically managing **medication prior authorizations**, including handling denials, formulary exceptions, and appeals.
-   **Exceptional English Fluency:** Superior spoken English, active listening skills, and a confident, warm phone presence suitable for communicating directly with U.S. patients, parents, and pharmacy reps.
-   **Healthcare & Insurance Background:** Proven experience in U.S. healthcare workflows, medical/pharmacy insurance verifications, and front-desk or patient care coordination.
-   **Pediatric Experience (Preferred):** Prior experience working in a pediatric practice, family practice, or dealing directly with parents/guardians is highly advantageous.
-   **Systems & Portal Competency:** Familiarity with CoverMyMeds, major US insurance portals, HIPAA-compliant communication tools, and standard EHR platforms (e.g., AthenaHealth, eClinicalWorks, or similar).
-   **Core Competencies:** High accountability, meticulous organization, independent problem-solving skills, and disciplined follow-through on open cases.

## Apply

[Apply at Staffing for Doctors](https://apply.workable.com/staffing-for-doctors/j/FE0A6E9CF0/apply)

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