Job Description

Prior Authorizations Specialist RN/MA- Medications/ Imaging We are seeking a detail-oriented and experienced Registered Nurse or Medical Assistant with strong knowledge of U.S. healthcare systems, insurance processes, and clinical workflows. This role will support care coordination by managing prior authorizations, processing medical records requests, and ensuring timely and accurate import of laboratory and diagnostic results into the electronic health record (EHR). This position plays a key role in reducing administrative burden for providers and improving patient access to care. Responsibilities: Prior Authorizations • Initiate, submit, and follow up on prior authorizations for medications, imaging, procedures, and other services. • Review clinical documentation to ensure medical necessity criteria are met. • Communicate with insurance companies, pharmacy benefit managers (PBMs), and diagnostic imaging centers to expedite approvals. • Document all authorization activities in the EHR, including status updates and determinations. Medical Records Management • Process inbound and outbound medical records requests in compliance with HIPAA and organizational policies. • Track the records' status to ensure timely receipt and release. • Communicate with external providers, hospitals, and diagnostic facilities to obtain required documentation. Lab and Imaging Results Importing • Retrieve, verify, and import laboratory and imaging results into the EHR with high accuracy. • Ensure results are properly categorized, indexed, and routed to appropriate providers. • Flag abnormal or urgent results per clinical protocols. Additional Responsibilities • Collaborate with providers, clinical staff, and administrative teams to support continuity of care. • Maintain up-to-date knowledge of payer policies and authorization requirements. • Participate in quality improvement initiatives related to care coordination and documentation accuracy. • Provide patient communication as needed regarding authorization status and next steps. Qualifications: • Active Registered Nurse (RN) license, or MA certifications. • 1+ years of experience preferred; experience in care coordination, case management, or utilization management strongly preferred. • Experience as a virtual assistant with a US Healthcare company. • Strong understanding of U.S. insurance rules, prior authorization processes, and medical terminology. • Experience with electronic health records (EHRs); familiarity with [MDHQ, Epic/Cerner/eClinicalWorks/etc] a plus. • Excellent attention to detail, organizational skills, and ability to manage multiple tasks simultaneously. • Strong English written and verbal communication skills. • Empathy and de-escalation skills. • Ability to work independently and collaboratively in a fast-paced environment. About Company: Welcome to Vida, where integrated healthcare meets unparalleled excellence in the greater Seattle area. At Vida, we bring together a dynamic team of Functional Medicine Physicians, Nutritionists, Chiropractors, Acupuncturists, Physical Therapists, and Massage Therapists, all united under one roof with a singular mission: to help you achieve your health and wellness goals. Our collaborative approach ensures that you receive the most effective treatment plans and outcomes. Our providers regularly engage in patient roundtable meetings, sharing insights and strategies to enhance your care. With the convenience of being just steps away from one another, our experts can easily consult with each other, ensuring seamless coordination and comprehensive support. At Vida, we believe that "Together is Better." Experience the synergy of a dedicated team working in harmony with you for a healthier, happier life. Join us at Vida, where your well-being is our passion!

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