Virtual Medical Assistant (Prior Authorization Specialist) (Fluent English required)

🚨 We’re Hiring: Virtual Medical Assistant (VMA) – Prior Authorization Specialist🏥 Department: Radiology📍 Remote Position🏢 Company: Metaplier🕒 Full-Time📅 Monday – Friday⏰ 8am-5pm CST (1hr break) (4pm-1am Cairo Time)Metaplier is seeking an experienced and highly organized Virtual Medical Assistant (VMA) – Prior Authorization Specialist to support our Radiology Department.The ideal candidate will have hands-on experience managing prior authorizations for imaging services and a strong understanding of payer requirements, medical necessity documentation, and radiology workflows.🔹 Responsibilities• Submit and manage prior authorization requests for radiology and imaging services• Work with multiple insurance carriers including commercial plans, Medicare Advantage, and Medicaid• Understand and navigate payer-specific authorization workflows and submission requirements• Utilize clinical decision support portals and evidence-of-coverage guidelines for imaging approvals• Review and extract medical necessity documentation from patient charts and EHR systems• Compile supporting clinical records including:Progress notesPrior imaging reportsLaboratory resultsEKG reportsRelevant clinical history Coordinate with providers, insurance companies, and radiology departments to ensure timely approvals • Understand CPT and ICD-10 code relationships and assist with accurate authorization submissions Maintain accurate documentation, follow-up records, and authorization status updates🔹 Qualifications & Requirements✅ Prior Authorization experience required✅ Strong understanding of end-to-end authorization submission workflows✅ Familiarity with radiology imaging modalities including MRI, CT, PET/CT, ultrasound, and X-ray✅ Knowledge of payer-specific submission requirements and turnaround expectations✅ Understanding of CPT and ICD-10 coding concepts related to imaging services✅ Experience using eClinicalWorks (ECW) strongly preferred✅ Ability to interpret and organize clinical documentation for medical necessity review✅ Strong English communication skills (written and verbal)✅ Fluent or near-native English required✅ Excellent organizational skills and attention to detail✅ Professional phone etiquette and ability to work independently✅ Stable internet connection and quiet remote work environment required🔹 What We’re Looking ForWe are looking for candidates who understand not only how to submit authorizations, but also how to think critically through the approval process by identifying the correct documentation, understanding radiology service requirements, and navigating insurance portals efficiently.Candidates should be comfortable using CPT reference guides and understanding how codes relate to imaging services and medical necessity requirements.🔹 Why Join Metaplier?💼 Competitive compensation based on experience📈 Opportunities for long-term career growth🌎 Fully remote work environment🤝 Collaborative and supportive team culture🏥 Work with leading healthcare organizations across the United States📩 Interested applicants are encouraged to apply with their resume and relevant experience.