Dedicated Healthcare Role Profile
Prior Authorization Virtual Assistant
Prevent care delays and administrative gridlock with a dedicated specialist tracking clinical notes, submitting payer requests, and monitoring approvals daily.
Core Daily Responsibilities & Tasks
- Reviewing provider orders and clinical notes to compile required medical necessity documentation.
- Submitting authorization requests via payer web portals, CoverMyMeds, and fax systems.
- Conducting daily proactive follow-up with commercial payers, Medicare Advantage, and Medicaid plans.
- Documenting authorization approval numbers, effective dates, and visit thresholds in the EHR.
- Coordinating peer-to-peer review scheduling between clinical providers and payer medical directors upon denial.
The Model: What Is Handled Remotely vs. Directed by You
Handled by Dedicated Employee:
- Compiling clinical charts for submission
- Payer portal PA submission
- Daily status follow-up & escalation
- Peer-to-peer review coordination
Directed by Your Practice:
- Conducting peer-to-peer physician calls
- Authorizing treatment plans
- Signing clinical letters of medical necessity
- Directing clinical care
Common EHR & Software Platforms
Our professionals have prior exposure or are trained to your specific configurations across:
CoverMyMedsAvailityOptum PA PortalCarelonEpic CareConnectathenaClinicals
Frequently Asked Questions
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