This is a remote position. Rockstar is hiring a full-time Prior Authorizations & Clinical Intake Virtual Assistant on behalf of our client, a home medical equipment and supply provider. This role specializes in prior authorizations, clinical intake, and medical records processing. The ideal candidate has experience reviewing patient documentation and is knowledgeable about identifying required clinical records, checking documentation completeness, and ensuring all necessary information is available before an order or authorization can be processed.
Key Responsibilities
Clinical Documentation & Chart Review
Review patient charts and medical records for completeness
Handle clinical intake and verify required documentation
Identify missing or incomplete clinical information
Ensure CMNs, clinical notes, and supporting documents meet payer requirements
Maintain accurate and organized patient records
Prior Authorizations & Insurance
Verify patient insurance eligibility and coverage prior to order fulfillment
Submit prior authorization requests to insurance payers and track them through to approval
Follow up proactively on pending or delayed authorizations to avoid delays in patient care
Stay current on payer-specific documentation requirements, including Medicare and Medicaid guidelines for durable medical equipment
Communication & Coordination
Communicate with physician offices to request missing signatures, notes, or supporting documentation
Coordinate with the sales and delivery team to ensure orders are ready to move forward once documentation is complete
Escalate documentation or authorization issues that require physician or payer intervention
Administrative Support
Enter and update patient and order information accurately within Brightree
Qualifications
Prior experience in DME (durable medical equipment), with strong hands-on skills in Medicaid and commercial insurance authorization processing
Brightree and Parachute experience preferred
Experience reviewing patient documentation and clinical records for completeness
Knowledge of prior authorization requirements and payer documentation standards, particularly Medicaid
Strong attention to detail with the ability to identify missing or incomplete information
Highly organized with strong recordkeeping habits
Comfortable working independently within a remote healthcare setting
Benefits
Competitive salary commensurate with experience.
Opportunities for professional development and growth.
Work in a dynamic and supportive team environment.
Make a meaningful impact by helping to build and strengthen families across the Globe.
