Medical Virtual Assistant

Calling Doctors office on behalf of patient to set up an appointment. Assisting/explaining Member with their Benefits Inquiry, and prescription refills. Verified patient insurance eligibility, coverage, and benefits prior to services. Checking CPT and Diagnosis Code if prior authorization is required, valid and billable. Assisting/explaining provider with their inquiries about benefits and claims. Assisting/explaining provider contract.

Performed end-to-end insurance verification, confirming coverage, benefits, and eligibility prior to services. Conduct outbound calls to patients to confirm insurance information, and resolve missing details. Collaborate with internal teams to support timely insurance clearance and efficient processing. Maintained accurate and detailed documentation in the EMR to ensure billing compliance. Collaborate with internal teams regarding prior authorization as needed.

Credentialing/Submitting application for Registered Doctors/Dietitian to major payors. Tracking application status, follow up with providers and payers, and resolve discrepancies in a timely manner. Maintain accurate and up-to-date records in credentialing databases and systems. Conduct primary source verifications through licensing boards, NPI registry, CAQH, state portals, and insurance carriers.