Healthcare Administrative Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Oversee patient registration, scheduling, and coordination of appointments.

• Conduct verification of insurance eligibility and interpretation of benefits.

• Supervise processes related to patient intake and referral management.

• Initiate, submit, and track prior authorization requests utilizing payer portals.

• Collaborate with providers and insurance companies to secure timely approvals.

• File insurance claims and keep track of claim statuses.

• Investigate claim denials, manage appeals, and resolve issues related to claim rejections.

• Perform follow-up on accounts receivable to ensure prompt reimbursement.

• Process Electronic Remittance Advice (ERA).

• Accurately post payments and reconcile remittances with clinical charges.

• Assist with payment reconciliation and financial reporting tasks.

• Oversee provider credentialing and enrollment processes.

• Aid in payer configuration and maintenance.

• Manage provider and member services, along with appeals and grievance processes.

• Administer medical records and handle requests for the release of information.

• Support daily medical office operations and practice administration tasks.

• Ensure that documentation and operational processes adhere to organizational policies.

⛳️ Requirements

• At least **3 years of practical experience** in a healthcare administrative or back-office operations role.

• Currently employed in a healthcare administrative setting.

• Strong familiarity with industry-standard systems, including:

• Payer portals such as **Availity, Optum/Change Healthcare, Waystar, Office Ally**, or payer-specific portals like **UHC Link, BCBS, and Aetna**.

• Electronic Health Record (EHR) and Practice Management systems.

• Healthcare clearinghouse platforms.

• Residing in the **United States**.

• Excellent analytical, organizational, and communication skills.

• Capability to accurately document and articulate operational workflows.

🏝️ Benefits

• Competitive salary and performance-based incentives.

• Comprehensive health and wellness benefits.

• Opportunities for professional development and career advancement.

• Supportive work environment with a focus on teamwork.

• Flexible work hours and potential for remote work options.