Prior Authorizations Specialist (Medical Assistant) - 1099 Contract in at Wheel
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Job Description
Wheel Medical Group is seeking Medical Assistants to join our network of world-class clinicians delivering virtual care.
About Wheel Medical Group
Wheel Medical Group is a physician owned professional corporation that serves patients across the United States; evolving the traditional care ecosystem by equipping the nation's most innovative companies with a premier platform to deliver high-quality virtual care at scale. We offer proven strategies and cutting-edge technologies to foster consumer engagement, build brand loyalty, and maximize return on investment. Wheel solutions include configurable virtual care programs, an intuitive consumer interface, and access to a nationwide network of board-certified clinicians. Discover how Wheel is transforming the future of healthcare by visiting www.wheel.com.
About the Role
As a Medical Assistant focused on Prior Authorizations on Wheels Clinical Operations team, you will be responsible for obtaining the approvals patients and clinicians need before medications can move forward across Wheels telehealth platforms. You will review clinical documentation, submit and track authorization requests, and communicate with clinicians and payers to ensure coverage requirements are met.
In this fully remote role, you will monitor requests end to end, resolve issues and denials, and maintain accurate, compliant records within the EMR. You will help facilitate timely patient care while supporting revenue cycle efficiency, and youll partner with billing, clinical, and patient support teams to keep authorizations moving smoothly across multiple telehealth platforms.
The ideal candidate has strong attention to detail, is comfortable navigating multiple EMR and payer systems at once, and communicates clearly with clinicians, payers, and patients. They stay current on payer requirements and telehealth regulations, and are motivated to identify and fix recurring authorization bottlenecks. They also escalate issues with prior authorizations to the RN team as needed.
This is a 100% remote, full-time (40 hours/week) position supporting a dynamic and rapidly growing virtual care organization. Shifts: Monday - Friday 8 am- 4 pm CST or 12 pm- 8 pm CST & Saturday/ Sunday/Monday 8 am- 4 pm CST
What Youll Do
Review patient medical records and clinician requests within the EMR to determine when prior authorization is required.
Submit and track prior authorization requests with insurance carriers to ensure timely approvals for medications ordered by Wheel clinicians.
Communicate with clinicians, insurance representatives, and patients to gather necessary documentation and clarify coverage requirements.
Verify insurance eligibility, benefits, and coverage limitations to help prevent claim denials or delays.
Maintain accurate, timely records of authorization requests, approvals, denials, and follow-up actions within the EMR and support ticketing systems.
Research and resolve authorization denials or discrepancies, coordinating with clinicians and payers as needed, and escalating clinical questions to licensed clinical staff.
Educate patients and clinicians on the prior authorization process, requirements, and expected timelines.
Monitor authorization trends and turnaround times, and report findings to the Clinical Operations team to support workflow improvements.
Collaborate with billing, clinical, and patient support teams to ensure seamless coordination of care and reimbursement across multiple telehealth platforms.
Stay current on payer requirements, telehealth regulations, and industry standards affecting prior authorizations.
Who You Are
Detail-oriented: precise in completing authorization forms, documentation, and follow-up activities.
Relationship-oriented: builds trust with clinicians, payers, and patients while balancing the needs of Wheel, our clients, and their patients.
Quick learner: proactive self-starter who becomes fluent in Wheels and each clients systems, payers, and policies.
Solution-focused communicator: clear, respectful, and effective across clinical, billing, and patient-facing conversations.
Qualifications
High school diploma or equivalent required; Associates or Bachelors degree in Healthcare Administration, Medical Assisting, or a related field preferred
Active Medical Assistant certification/registration where required by state (e.g., CMA, RMA, or state-recognized equivalent) preferred
13 years of experience in prior authorization, medical billing, or revenue cycle operations
Proficiency with electronic health records (EHR), practice management software, and insurance portals; experience with multiple EMR systems a plus
Strong analytical skills and ability to review patient and insurance information accurately and efficiently
Strong verbal and written communication skills for interacting with clinicians, payers, and patients
Problem-solving ability to resolve authorization issues and denials effectively
Working knowledge of HIPAA, insurance policies, and payer-specific authorization requirements
Advanced computer skills, including typing speed, email, internet research, and working across multiple browser windows and systems simultaneously