Healthcare Administrative Specialist (Part-Time AI Model Training)

Role Overview

Join our collaboration with Mercor as a Healthcare Administrative Specialist, contributing your expertise in the crucial administrative and operational functions that sustain healthcare organizations. Your primary responsibility involves detailed insight and ownership over one or more core healthcare administrative workflows that form the backbone of medical practices, hospitals, or health plans.

Core Responsibilities

• Manage patient access and front-end operations including patient registration, scheduling, insurance verification, benefits analysis, intake, and referral oversight.
• Oversee prior authorizations and utilization processes by initiating, submitting, and monitoring authorization requests through payer portals.
• Handle claims and revenue cycle duties such as claim submissions, tracking, resolving denials and appeals, and accounts receivable follow-ups.
• Conduct remittance and payment posting tasks, including processing electronic remittance advices, posting payments, and reconciling them with clinical charges.
• Direct provider and payer operations including credentialing, provider enrollment, payer configuration, appeals, grievances, and managing member/provider services.
• Administer health information and daily practice operations such as medical records management, release of information, and routine office functions.

Required Qualifications

• Minimum three years of consistent, hands-on experience in healthcare administrative or back-office roles.
• Proven expertise working with healthcare systems including payer portals (e.g., Availity, Optum/Change Healthcare, Waystar, Office Ally, UHC Link, BCBS, Aetna), EHR/practice management software, and clearinghouses.
• Currently employed in a healthcare administrative capacity within the United States.

Preferred Professional Backgrounds

• Practice Administrator, Medical Office Manager
• Revenue Cycle Specialist, RCM Analyst
• Medical Billing Coordinator, Full-Cycle Biller
• Patient Access Lead, Intake, Referral Coordinator
• Prior Authorization Specialist
• Denials and Claims Resolution Specialist
• Credentialing and Provider Enrollment Specialist
• Health Plan/Payer Operations including claims management, appeals, provider setup
• Health Information Management or Medical Records Administration

Additional Information

Note that this opportunity focuses on operational workflow expertise in healthcare administration and does not encompass medical coding or clinical healthcare roles.