Senior Medical Office Administrator (Insurance Authorization Specialist), Bilingual (English/Spanish
FlexStaff Careers
FlexStaff is seeking a SeniorMedical 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 communicationResponsibilities:Insurance Authorization & Revenue Cycle OperationsLead 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 AdministrationOptimize 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 & ComplianceAudit 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 & LeadershipTrain and supervise administrative staff on insurance processes and standards.Act as escalation point for complex issues and promote best practices.
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