Healthcare Administrative Specialist

About the Role

This position is designed for experienced professionals in healthcare administration and operations with practical knowledge of the backend workflows that support medical providers, hospitals, and health insurance plans. The role focuses on administrative areas including patient access, prior authorization, claims handling, revenue cycle management, provider credentialing, payer operations, and managing health information. It is strictly administrative and operational, without clinical or medical coding duties.

Key Responsibilities

• Oversee and assess processes related to patient registration, appointment scheduling, insurance eligibility verification, benefits interpretation, patient intake, and referral coordination.
• Manage prior authorization activities such as initiating, submitting, tracking, and resolving authorization requests using payer portals.
• Administer claims and revenue cycle operations including submission, status monitoring, denial handling, appeals, accounts receivable follow-up, and resolving rejections.
• Process remittance and payment workflows including electronic remittance advice, payment posting, and reconciliation tasks.
• Support provider and payer operations like credentialing, provider enrollment, payer setup, appeals, grievances, and member/provider services.
• Handle health information management including medical records administration, information release, and daily practice operational duties.
• Utilize detailed knowledge of healthcare systems and administrative workflows to ensure successful project delivery and quality outcomes.

Qualifications

• At least three years of hands-on experience in healthcare administration, operations, or back-office roles.
• Currently employed in a healthcare administrative position.
• Direct familiarity with healthcare administrative systems such as payer portals, electronic health records (EHR) platforms, practice management systems, or clearinghouses.
• Experience with platforms like Availity, Optum/Change Healthcare, Waystar, Office Ally, UHC Link, BCBS, Aetna, or equivalent systems.
• Comprehensive understanding of healthcare administrative processes, documentation, and operations.
• Exceptional attention to detail, problem-solving aptitude, and strong written communication abilities.
• Must reside within the United States.

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 or Intake/Referral Coordinator
• Prior Authorization Specialist
• Denials or Claims Resolution Specialist
• Credentialing or Provider Enrollment Specialist
• Health Plan or Payer Operations Specialist
• Health Information Management or Medical Records Administrator

Compensation and Terms

• Competitive hourly pay ranging from $40 to $50 per hour.
• Weekly payment schedule.
• Engagement as an independent contractor.