Healthcare Administration Specialist

About the Role

This position is crafted for professionals experienced in healthcare administration and operations, emphasizing support for medical practices, hospitals, and health plans. The focus lies in healthcare administrative workflows including patient access, prior authorizations, claims management, revenue cycle operations, provider enrollment, payer operations, and health information management. This is a non-clinical role dedicated to healthcare administrative and operational functions.

Key Responsibilities

• Oversee and optimize patient registration, appointment scheduling, insurance eligibility checks, benefits interpretation, patient intake, and referral management processes.
• Coordinate prior authorization procedures by initiating, submitting, tracking, and resolving authorization requests via payer portals.
• Manage claims processing and revenue cycle tasks such as submission, monitoring claim status, handling denials and appeals, accounts receivable follow-up, and resolving claim rejections.
• Conduct review and processing of remittance and payments, including electronic remittance advice (ERA), payment posting, and reconciliation activities.
• Facilitate provider and payer administrative tasks like credentialing, provider enrollment, payer configuration, handling appeals, grievances, and supporting member/provider services.
• Administer health information workflows encompassing medical records management, release of information, and daily practice operations.
• Leverage practical experience with healthcare administrative systems to ensure high standards and successful project delivery.

Required Qualifications

• Minimum of three years of consistent, hands-on experience in healthcare administration or back-office operations.
• Currently engaged in healthcare administrative work.
• Proficient with healthcare administrative systems including payer portals, electronic health record (EHR) systems, practice management platforms, or clearinghouses.
• Experienced with platforms such as Availity, Optum/Change Healthcare, Waystar, Office Ally, UnitedHealthcare Link, Blue Cross Blue Shield, Aetna, or similar systems.
• Strong knowledge of healthcare administrative workflow, documentation, and operational procedures.
• Excellent detail orientation, problem-solving abilities, and effective written communication skills.
• Residency within the United States is required.

Preferred Professional Backgrounds

• Practice Administrator or Medical Office Manager
• Revenue Cycle Specialist or RCM Analyst
• Medical Billing Coordinator or Full-Cycle Biller
• Patient Access Lead, Intake, or Referral Coordinator
• Prior Authorization Specialist
• Denials or Claims Resolution Specialist
• Credentialing or Provider Enrollment Specialist
• Health Plan or Payer Operations Specialist
• Health Information Management (HIM) or Medical Records Administrator

Compensation and Engagement

• Competitive hourly pay ranging from $40 to $50.
• Payments issued on a weekly basis.
• Engagement as an independent contractor.