Healthcare Administrative Specialist

Map, document, and clarify the day-to-day administrative and operational workflows that keep medical practices, hospitals, and health plans functioning. You will capture the exact steps performed in the actual payer portals, EHRs, and practice-management tools you use, and own one or more back-office areas from patient intake through payment and provider/payer operations. Key Responsibilities

• Actively own one or more administrative workflows, and document the end-to-end steps, inputs, and decision points used in your current tools.
• Demonstrate how tasks are completed in payer portals, EHR or practice-management systems, and clearinghouses, by describing the precise actions and sequence required to achieve outcomes.
• Track common exceptions, denials, or escalations and record the resolution steps and criteria used to decide next actions.
• Work across patient, provider, and payer touchpoints to explain interactions that impact eligibility, authorizations, claims, remittance, and provider enrollment.

• Patient Access and Front-End , including registration, scheduling, insurance and eligibility verification, benefits interpretation, intake, and referral management.
• Prior Authorizations and Utilization Support , initiating, submitting, and tracking authorizations through payer portals.
• Claims and Revenue Cycle , claim submission, status tracking, denials and appeals, accounts receivable follow-up, and resolution of rejections.
• Remittance and Payment Posting , processing electronic remittance advice, payment posting, and reconciling payments against clinical charges.
• Provider and Payer Operations , credentialing, provider enrollment, payer configuration, appeals and grievances, and member and provider services.
• Health Information and Practice Administration , medical records administration, release of information, and daily practice or office operations.

• Minimum 3 years of daily, hands-on experience in healthcare administrative or back-office roles.
• Current employment in a healthcare administrative role, performing the workflows listed above.
• Direct, practical experience with the systems that run this work, for example payer portals such as Availity, Optum or Change Healthcare, Waystar, Office Ally, or individual payer hubs like UHC Link, BCBS, and Aetna, and with EHR or practice-management platforms and/or clearinghouses.
• Ability to describe exact steps, fields, and decision criteria used in live operational tools.

• 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 roles involving claims, appeals and grievances, or provider configuration
• Health Information Management or Medical Records administrator

• Location: Remote.
• Employment type: hourly.

• Rate: 40 - 50 hourly.

• Must be based in the United States.
• Must currently be working in a healthcare administrative role and have the hands-on experience described above.