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

1. Prior Authorizations & Insurance Verification: Secure prior authorizations for diagnostic testing (CT scans, MRIs, lab work) and verify active insurance coverage before patient visits.
2. 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.
3. 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.