Healthcare Virtual Assistant

Who We Are

EDGE is building a bridge between Top Global Talent and the US Healthcare & Insurance Industry. We are on a mission to create a borderless network of exceptional talent with people at the center of everything we do. See our values and more on onedge.co.

Role Overview

We are looking for virtual healthcare professional for US-based healthcare providers. The ideal candidate will possess a healthcare-related degree and a solid foundation in the US healthcare ecosystem.

Operating as a key member for US based clinics and healthcare practices, this professional will act as a critical liaison between patients, healthcare providers, and insurance companies. The position requires a meticulous, tech-savvy individual capable of navigating complex insurance portals and electronic health records, while ensuring patients receive timely access to the care they need.

Key Responsibilities

1. Insurance Verification & Eligibility

• Conduct comprehensive eligibility checking and benefits verification for patients prior to their scheduled appointments.
• Accurately interpret complex insurance policies, differentiating between PPO, HMO, and Medicare/Medicaid guidelines.
• Determine patient financial responsibilities, including deductibles, copays, and coinsurance , and clearly document these findings within the practice management system.

2. Prior Authorization Management

• Prepare, compile, and submit prior authorization requests to insurance companies via web portals, fax, or phone.
• Review clinical documentation (progress notes, lab results, physician orders) to ensure medical necessity criteria are met before submission.
• Proactively track the status of pending authorizations, manage appeals for denied claims, and expedite urgent requests to prevent delays in patient care.

3. Data Integrity & Compliance

• Review and interpret Explanation of Benefits (EOB) to identify and resolve authorization-related billing discrepancies.
• Maintain strict confidentiality and ensure full compliance with HIPAA regulations and US healthcare data privacy laws.
• Accurately update Electronic Health Records (EHR) and Practice Management Systems with approved authorization numbers, effective dates, and covered service codes.

Requirements

• Education: A healthcare-related degree (e.g., Nursing, Pharmacy, Healthcare Administration, Public Health) is highly preferred.
• Experience: Must have 1–2 years of direct experience in the US Healthcare industry, with a proven track record in prior authorizations and insurance verification.
• Core Knowledge: Deep understanding of US insurance concepts, including PPO, HMO, EOBs, copays, and patient benefits .
• Technical Skills: Proficiency in navigating insurance portals (e.g., Availity, Optum, Covermymeds) and electronic health record/practice management systems (e.g., ECW, Tebra, Dentrix etc).
• Competencies: Exceptional attention to detail, strong analytical skills, excellent written and verbal English communication , and the ability to work independently in a fast-paced environment.

What We Offer

At Edge, we believe our greatest innovation is our people. When you join our globally minded team, you’ll thrive in a supportive, forward-thinking environment where your growth and well-being are our top priorities.

We protect your peace of mind by offering a competitive starting base salary of USD 750 , comprehensive health and life insurance, and a balanced leave package designed to support you and your family. This includes 14 annual vacation days with leave encashment options, 12 calendar weeks of paid maternity leave, 2 calendar weeks of paid paternity leave, and all mandated public holidays by Pakistani Law.

Discover a career where you can truly push boundaries, fully backed by a team that invests in your future and respects your rights.

Our Hiring Process

1. Application Review: Submit your application and resume. Our team carefully evaluates all candidates to ensure a good fit.
2. Edge Interview: You'll be invited to connect with a representative from Edge to present a detailed and tailored fit to your profile.
3. Client Interviews: Successful candidates finish an onboarding & training phase and are placed in client interviews to showcase their skills and align with specific client needs.
4. Final Selection: Once a good match is made, you’ll join the Edge Global Talent Community, ready to make an impact in the world of healthcare.

Why Choose Edge?

• Be part of a dynamic, global community that values your skills.
• Work on projects that make a real difference in people's lives.
• Enjoy a clear path for career growth and development.
• Be a part of a people-first and talent-centric culture.

Talent Boilerplate

At Edge, we’re on a mission to create a world where geographic borders are no longer a barrier for people to obtain full-time employment and fair wages. That’s why we’ve created a global hiring network that seamlessly connects exceptional talent from all over the world with businesses in North America that most need to fill positions. The Edge Talent Network is a community of like-minded professionals through which you can unlock your potential, showcase your skills, and earn what you’re worth.

Equal Opportunity Employer Statement

Edge is proud to be an equal-opportunity employer. We are committed to fostering a diverse and inclusive work environment. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, physical or mental disability, age, veteran status, or any other legally protected basis.