Receptionist & Prior Authorization Specialist (Primary Care)

We are seeking a proactive, highly organized Front Desk Receptionist & Prior Authorization Specialist to support a brand-new primary care practice launching this fall. Supporting a solo practitioner, you will serve as the operational backbone of the office-handling patient calls, managing scheduling, facilitating medication refill requests, and taking full ownership of insurance eligibility and diagnostic prior authorizations.

Because this is a solo medical practice, the ideal candidate is an independent self-starter who excels at multi-tasking and understands U.S. insurance workflows inside and out. Hands-on experience securing diagnostic prior authorizations (CTs, MRIs, specialty imaging, etc.) is an absolute requirement.

Schedule & Working Environment

• Status: Full-Time (40 Hours / Week)
• Start Date: Practice Opening October 5th (Onboarding prior)
• Schedule (US Eastern Standard Time - EST):
• Mon, Tue, Thu: 8:30 AM - 4:30 PM EST
• Wednesday: 11:00 AM - 7:30 PM EST
• Friday: 8:30 AM - 12:30 PM EST (Half-Day)

Top 3 Daily Tasks

• Prior Authorizations & Insurance Verification: Secure prior authorizations for diagnostic testing (CT scans, MRIs, lab work) and verify active insurance coverage before patient visits.
• Inbound Phone Operations & Scheduling: Answer incoming calls, handle appointment bookings, answer patient inquiries, and step in if patients need assistance with the automated intake system.
• Medication Refill & Prescription Requests: Field incoming phone requests for medication refills, gather clinical details, and route them to the physician according to practice protocols.

Core Responsibilities

• Prior Authorization Ownership (Non-Negotiable): Submit, track, and follow up on prior authorization requests for diagnostic imaging (MRIs, CTs, Ultrasounds) and medications with commercial and government payers.
• Front Desk & Call Management: Manage high-touch inbound phone calls professionally, maintain practice scheduling, and address administrative patient inquiries.
• Clinical Administrative Support: Receive and process medication refill calls; compile pharmacy details and chart notes for provider review.
• Automated Intake Backup: Monitor the practice's automated patient check-in platform, assisting patients remotely when manual intervention is required.
• Consult & Fax Management: Process, track, and follow up on outgoing consultation faxes, medical record requests, and specialist reports.
• EMR & Platform Navigation: Utilize Alasia Health and Ambient AI to document patient communications, record details, and manage daily workflows.

Requirements

Required Qualifications

• Prior Authorization Experience (NON-NEGOTIABLE): Demonstrated hands-on background obtaining diagnostic (CT, MRI) and medication prior authorizations directly from insurance companies.
• Insurance Verification Expertise: Thorough knowledge of U.S. health insurance plans, co-pays, deductibles, and eligibility checking.
• Healthcare Front Office Background: Minimum 2+ years of experience in medical reception, patient scheduling, or primary care front-desk administration.
• Schedule Agreement: Ability to work the exact designated 40-hour shift structure (including Wednesday late shifts and half-day Fridays).
• Communication & Demeanor: Fluent spoken and written English; warm, welcoming, and reassuring phone presence.
• Remote Setup: A private, HIPAA-compliant home office with a reliable computer, high-speed internet, and a clear headset.

Preferred Qualifications

• Solo Practitioner Support: Experience working in a boutique, primary care, or small solo-provider practice environment.
• EMR/AI Tool Familiarity: Experience using Alasia Health, Ambient AI, or comparable modern EMR platforms.

Ideal Candidate Profile

You are an articulate, resourceful virtual assistant who thrives in a solo-provider setting. You treat prior authorizations as a high-priority mission, take pride in keeping patient schedules full and organized, and love providing top-tier service over the phone.