SENIOR MEDICAL ADMIN Bilingual Spanish/PIP & Legal Experience Req

Job Description

Job Description

SENIOR MEDICAL ADMIN

Bilingual Spanish | PIP & Legal Experience Required

We are a busy Orthopaedic Surgery & Sports Medicine practice based in Roselle Park, NJ.  We are looking for a full-time, experienced Senior Medical Admin to join our team. This is not an entry-level medical office or front desk position. This role is responsible for critical administrative functions including medical records, MRI coordination, treatment precertification, disability, attorney communication, and preparation of billing documentation. The ideal candidate will take ownership of these processes, manage multiple priorities, and follow each task through to completion.

You Must Have:

• Fluency in both English & Spanish, oral AND written. This is required.

• Minimum 3 years of experience working in a medical office.

• Prior experience working with PIP/No-Fault automobile insurance claims.

• Prior experience communicating and working with attorney offices regarding patient treatment.

• Strong knowledge of medical terminology, medical records, insurance verification & authorization processes.

• Excellent written and verbal communication skills with strong attention to detail.

• Strong computer skills and the ability to efficiently work within an electronic medical record system, Microsoft Office, Google Workspace & insurance portals.

• Exceptional organizational skills and the ability to manage multiple open tasks, deadlines & necessary follow-up.

• Trustworthy & accountable- able to work independently, recognize what needs to be done, and follow responsibilities through to completion without micromanaging.

• Flexible- being a small business often means having to take an “all hands on deck” approach.

Candidates who do not meet the bilingual, medical-office experience, PIP and attorney-office requirements will NOT be considered.

Job Responsibilities Include:

• Managing incoming & outgoing medical record requests from patients, attorneys, insurance carriers, medical facilities and other authorized parties.

• Coordinating MRI & diagnostic imaging approvals, including obtaining necessary clinical documentation, communicating with insurance carriers and imaging facilities, tracking authorization status & scheduling approved studies.

• Managing precertification & authorization for treatment, procedures and diagnostic testing, including submission of supporting documentation and timely follow-up on pending requests.

• Tracking outstanding authorizations and promptly addressing delays, denials or requests for additional information.

• Coordinating and completing patient disability paperwork upon receipt, ensuring forms are completed accurately and returned promptly to patients, employers, insurance carriers and/or other requesting parties.

• Communicating regularly & professionally with attorney offices regarding patient treatment status, upcoming care, outstanding approvals and other treatment-related matters.

• Providing requested treatment updates and documentation to authorized referral sources and legal offices.

• Maintaining complete & accurate patient records, including documentation of authorizations, communications, appointments and treatment status.

• Preparing complete billing packets for submission to our billing company and ensuring all required patient, insurance, clinical & supporting documentation is included and accurate.

• Reviewing documentation for completeness and identifying missing information before billing packets are submitted.

• Coordinating with the physician, Practice Manager, clinical staff, billing company, attorney offices, insurance carriers and outside facilities to ensure continuity of patient care.

• Maintaining organized systems for tracking pending medical records, MRI approvals, precertifications and other outstanding administrative matters.

• Promptly completing delegated tasks from the doctor and Practice Manager.

• Protecting patients’ rights by maintaining confidentiality of all patient information.

• Assisting with other administrative responsibilities as needed in a small, team-oriented medical practice.

The Right Person for This Position:

You are organized enough that things do not fall through the cracks. You don't simply send an authorization request- you track it until there is an answer. You don't simply forward paperwork- you make sure it is complete. You communicate well with patients, attorneys, insurance companies and coworkers, and you understand that timely follow-up directly affects both patient care and the operation of the practice. We are looking for someone who takes ownership of their work, can prioritize independently and does not require micromanagement.