Medical Office Administrator (Insurance Authorization Specialist), Bilingual (English/Spanish)

FlexStaff is seeking a Senior Medical Office Administrator with experience in Healthcare Insurance Authorization and Revenue Cycle Operations for our Client, a Prosthetics and Orthotics Lab, located in Manhattan, NY.

Requirements:

• High school diploma or equivalent required.
• Advanced knowledge of medical insurance verification, prior authorization processes, and reimbursement methodologies.
• Prior experience in healthcare billing, collections, or revenue cycle operations required.
• Bilingual English/Spanish.

Schedule: Monday- Friday, 8:30am-5:30pm.

This is Temp-to-Hire role.

In this role you will be serving as the lead specialist for insurance verification, benefits investigation, prior authorizations, and re-authorizations using payer portals, electronic systems, and direct payer communication

Responsibilities:

• Insurance Authorization & Revenue Cycle Operations
• Lead insurance verification, benefits investigation, prior authorizations/re-authorizations.
• Interpret payer policies, coverage criteria, and reimbursement rules.
• Validate eligibility, deductibles, co-insurance, and OOP maximums before services.
• Resolve authorization issues and denials with clinicians and billing.
• Track turnaround times and escalate delays; report key metrics.
• Maintain organized filing for audits and compliance.
• Work Process Management & Technical Administration
• Optimize workflows for authorizations, scheduling, documentation, and billing readiness.
• Create and maintain SOPs; coordinate clinician schedules with authorizations.
• Ensure daily billing readiness; use practice management systems to track status.
• Quality Assurance & Compliance
• Audit authorization accuracy, documentation completeness, and billing readiness.
• Identify trends and gaps; recommend corrective actions.
• Ensure compliance with payer, state, and federal regulations; retrain staff as needed.
• Staff Training & Leadership
• Train and supervise administrative staff on insurance processes and standards.
• Act as escalation point for complex issues and promote best practices.