Bilingual Medical Insurance, Administrative Specialist – Orthopedics

This is a fully remote position, open to applicants in Nicaragua, +5 more countries.

📋 Description

• Manage a substantial daily influx of incoming and outgoing calls, which includes inquiries from new patients, follow-ups, opportunities missed, and outreach to inactive patients.

• Transform patient inquiries into scheduled appointments.

• Maintain consistent and proactive follow-up until conversion is successfully achieved.

• Conduct comprehensive insurance verification, covering aspects like active coverage, plan specifics, patient obligations, deductibles, copays, coinsurance, and out-of-pocket maximums.

• Clarify financial responsibilities to patients via phone communication.

• Obtain prior authorizations.

• Navigate through various Commercial plans, including HMO/PPO, Aetna, Cigna, and Humana.

• Manage Personal Injury PIP/Workers' Comp cases.

• Oversee calendars, scheduling, and follow-up documentation within eClinicalWorks (eCW).

• Foster relationships with patients and referral sources, including attorneys and physicians.

• Contribute to the growth of the practice.

⛳️ Requirements

• Minimum of 1 year of practical experience using eClinicalWorks (eCW).

• Previous experience in Orthopedics, Neurology, or Pain Medicine.

• Hands-on experience managing the complete insurance verification process.

• Experience in obtaining prior authorizations.

• Familiarity with handling Commercial insurances and Personal Injury (PIP/Workers' Comp) claims.

• Demonstrated success in managing high-volume medical calls within a metrics-driven environment.

• Clear, confident, and friendly English phone communication skills.

• Highly organized and self-driven.

• Comfortable with accountability based on performance metrics.

• Full-time contractor role, requiring 40 hours per week.

• Availability from Monday to Friday, within the Eastern Time Zone.

🏝️ Benefits

• Competitive compensation package.

• Opportunities for professional growth and development.

• Supportive work environment focused on teamwork and collaboration.