Virtual Assistant for Psychiatry Practice

Title: Virtual Assistant — Psychiatry Practice Operations & Medical Billing Support Category: Admin Support / Virtual Assistant — Healthcare & Medical Billing Budget Type: Hourly, via Upwork Hourly Protection (Work Diary required). Starts at 10–15 hrs/week for a paid 2-week shadow/training period, scaling toward 20–35 hrs/week ongoing based on performance and patient volume. Rate and hour increases reviewed at day 30, with a follow-up review at day 45 if needed. Schedule Requirement: Daily availability 6:30 PM–11:30 PM IST (9:00 AM–2:00 PM US Eastern) is required — this covers core business hours, live portal monitoring, and safety-escalation availability. Applicants who can't reliably cover this window won't be a fit regardless of other qualifications. Overview: Let's Thrive Mental Health is a precision interventional psychiatry practice (PMHNP-led, based in Coral Gables, FL). Our Healthie EHR, intake flows, forms library, scheduling rules, billing handoffs, and safety-escalation protocols are already fully built and tested — this is not a build role. We're hiring a VA to operate that system day-to-day: patient communication, scheduling, refill processing, insurance verification, billing support, and front-line safety-message triage (escalate, never decide). You'll be trained directly from our existing written operations manual and a dedicated billing training guide — you're learning an established system, not inventing one. Once ramped, you'll have real latitude on routine tasks; you don't need to ask permission for everyday judgment calls, but anything touching money outside pre-approved parameters, anything clinical, and anything safety-related always gets escalated, never decided independently. Important — read before applying: This role involves access to real patient health information (PHI) once ramped. It is not a test-data role. A signed confidentiality/NDA agreement and a Business Associate Agreement (BAA) are required before any live PHI access — no exceptions, no early access. A background check is required before live access is granted. Mandatory HIPAA/security training must be completed (materials provided) before go-live, and refreshed annually. The first 2 weeks are shadow/training with limited or no independent PHI access. No local storage of PHI, ever — no screenshots, no exported spreadsheets, no personal notes containing patient information. Everything stays inside Healthie, Spruce, and the other provided systems. Payment data is tokenized only. You will never view, type, or store a raw credit card number anywhere, including in chat or portal messages — all card-on-file charges run through Stripe/Healthie's tokenized processing. You do not need professional liability/E&O insurance for this role. Every task that could create clinical or billing liability is explicitly escalated rather than decided by you, and that liability stays with the practice. This contract is with you personally — no subcontracting or delegating access to a third party, ever. Access is granted via a shared password manager with 2FA — never through chat or email — and is revoked immediately at contract end or pause. All local data/materials must be deleted and deletion confirmed in writing at offboarding. You'll need a secure, updated personal device and must never access the account over public/unsecured wifi. Self-reported errors are treated differently from concealed ones. If you catch a mistake — a missed message, a billing entry error, anything — report it within 24 hours and it gets corrected together, no penalty for the honest catch. Concealing an error is grounds for immediate termination. Payment & Performance Terms: All hours logged and paid via Upwork Work Diary — no manual timesheets, no off-platform payment. Weekly hour cap set in advance each week; work beyond the cap requires prior approval. Hours are unpaid when you're out (standard for hourly contracts). Indian public holidays don't automatically align with US ones — flag any planned time off at least 1 week in advance so coverage can be arranged; safety-escalation monitoring is never left unattended. Upwork handles currency conversion and payment processing; you're responsible for your own local tax obligations in India. Either party may end the contract with notice. Confirmed unauthorized PHI access, concealment of an error, or a confidentiality breach ends the contract immediately, without notice period. Full Scope of Work: 1. Portal & Patient Communication Triage — monitor the Healthie portal inbox daily and categorize messages per the existing triage protocol (1), respond directly to non-clinical questions — scheduling, portal access, general practice info (2), route clinical/urgent messages per the escalation SLA (3), log every message and its resolution (4), manage the after-hours queue and flag anything needing next-business-day follow-up (5) 2. Scheduling & Calendar Management — book/reschedule/cancel per the configured appointment-type rules (6), maintain the waitlist and fill cancellations (7), send day-of reminders and confirm attendance (8), manage protected urgent-access slot bookings correctly (9), flag calendar conflicts or availability gaps (10) 3. New-Patient Onboarding Execution — send the welcome sequence on every new booking (11), track intake-packet completion and send reminders per the lead-time rule (12), confirm all required forms/consents are signed before the visit (13), send the post-visit welcome packet and portal instructions (14), execute the first-30-days touchpoint cadence (15) 4. Insurance & Eligibility — run eligibility verification before every new-patient visit and log results in the chart (16), flag missing/expired insurance info to the patient before the visit (17), track prior-authorization requests and follow up on pending ones (18), maintain the payer-specific notes reference (19) 5. Billing & Medical Billing Support — prepare and submit encounter data to the billing/RCM workflow using provider-confirmed CPT/ICD-10 codes only — never assigning codes independently (20), post payments and reconcile against expected reimbursement (21), follow up on outstanding claims and unpaid balances (22), log denial reasons, route anything needing clinical input back to the provider, resubmit routine corrections per SOP (23), handle patient-facing billing questions — balance explanations, pre-approved payment plans, receipt requests (24), generate and send superbills for self-pay/out-of-network patients (25), process card-on-file charges for no-shows/late cancellations through tokenized payment methods only — never handling a raw card number (26), maintain the AR aging report and flag accounts past the defined threshold (27), support month-end billing close and reconciliation against QuickBooks (28), escalate any billing discrepancy or suspected coding error rather than resolving it independently (29) 6. Prescription-Refill Processing — receive and log refill requests through the defined channel (30), confirm PDMP-check and appointment-required rules are met before any controlled-substance refill proceeds (31), route anything outside routine refill parameters to the provider (32), maintain the pharmacy communication log (33) 7. Safety-Escalation Front-Line Response — apply the crisis-detection protocol to every incoming message (34), escalate to the provider within 5 minutes of flagging a safety message; provider or named backup [backup contact name/number provided at onboarding] acknowledges within 15 minutes during business hours — after-hours follows the existing crisis-routing protocol first (35), document every safety-related contact in the required format (36), confirm acknowledgment from the provider or backup on every escalation, and follow up if none arrives within the SLA window (37) 8. Documentation & Chart Support (non-clinical) — upload and file external records/labs to the correct chart location (38), prep chart data ahead of visits for provider review (39), maintain chart-audit tracking per the QA cadence (40), send referral/coordination letters using approved templates only (41) 9. Cancellation, No-Show & Payment Follow-Up — enforce the 24-hour cancellation/no-show fee policy (42), send no-show follow-up and rebooking prompts (43), track and follow up on failed payments (44) 10. Reporting & Admin — pull weekly/monthly operational reports (45), maintain the KPI dashboard against access standards (46), prepare the monthly ops summary (47), maintain the credentialing/license renewal calendar and flag upcoming deadlines (48) 11. Communication Automations Monitoring — confirm reminder/no-show/re-engagement sequences are firing correctly (49), flag automation failures or patient complaints about missed/duplicate messages (50) 12. Membership & Subscription Admin — process membership enrollments and cancellations (51), monitor for failed/declined membership charges and follow up (52), track program/track enrollment separately from 1:1 scheduling (53) 13. Cross-Platform Coordination — keep the practice's tracking system updated in parallel with Healthie (54), manage the Spruce messaging/fax queue (55), flag any tool or integration that's out of sync (56) 14. Compliance & Security (Day-to-Day) — follow minimum-necessary access at all times (57), complete required training before live access and annually after (58), report any suspected security or privacy incident immediately (59), maintain 2FA and secure-device practices at all times (60) Explicitly not in scope — always escalate instead:
Independent clinical judgment or triage decisions · independent CPT/ICD-10 code assignment · prescribing or medication advice of any kind · final decision-making on any safety escalation · independent claims submission outside the established review step · patient contact outside approved channels/scripts on clinical topics · waiving fees or granting billing exceptions without prior approval Ramp Plan:
Weeks 1–2: shadow/training on the existing operations manual and billing guide, supervised live sessions, no independent PHI access. Weeks 3–4: independent on routine tasks with regular spot-checks, especially on billing entries and safety-message routing. Day 30 review — pass criteria: zero unescalated safety messages · at least 95% of messages meeting the response-time SLA · zero card-data handling violations · billing entries accurate on a random spot-check of at least 10 entries. Meeting these confirms the move to standard rate/hours. Falling short identifies specifically what ne˜eds more support, with a follow-up review at day 45. You're a strong fit if you: Have real experience in US medical billing/RCM support, patient scheduling, or healthcare VA work — not general VA experience alone Are comfortable with structured SOPs and following an established system precisely, rather than improvising your own process Can distinguish "handle it" from "escalate it" reliably, especially on anything billing- or safety-related Are comfortable with a background check, signed NDA/BAA, mandatory HIPAA training, and no subcontracting Can reliably cover 6:30–11:30 PM IST daily Are looking for an ongoing role, not a short-term project Ongoing Deliverables: Daily portal/message triage per SOP with logged resolutions Weekly scheduling and refill processing with zero missed controlled-substance protocol checks Billing support: eligibility checks, payment posting, AR follow-up, denial logging, superbill generation Monthly ops report and KPI dashboard maintained Zero unescalated safety messages, zero unreported errors To apply: Describe your experience with US medical billing or healthcare VA work specifically (not general VA work). Confirm you're comfortable with a background check and mandatory HIPAA training before live PHI access. Confirm your available weekly hours and ability to cover 6:30–11:30 PM IST daily. Write a 2–3 sentence sample reply to this scenario: a patient messages the portal asking to skip this month's no-show fee because they forgot their appointment. Show us how you'd respond.