Healthcare Admin Specialist - Operations

Role Responsibilities

• Evaluate and improve administrative workflows in healthcare settings, focusing on patient access and front-end operations.
• Design efficient processes for prior authorizations and utilization support using real-world tools.
• Review and manage claims and revenue cycle activities, ensuring timely submission and resolution.
• Develop strategies for remittance and payment posting to align with clinical charges.
• Collaborate with provider and payer operations to enhance credentialing and enrollment processes.

Qualifications

• Must-Have: 3+ years of daily, hands-on experience in a healthcare administrative/back-office role.
• Direct experience with payer portals (Availity, Optum/Change Healthcare, Waystar, Office Ally, or individual payer hubs like UHC Link, BCBS, Aetna).
• Experience with EHR/practice-management platforms and/or clearinghouses.
• Currently working in a healthcare administrative role.
• Based in the United States.
• PREFERRED: Background as a Practice Administrator, Medical Office Manager, or Revenue Cycle Specialist.
• Experience as a Medical Billing Coordinator, Full-Cycle Biller, or Patient Access Lead.
• Skills as a Prior Authorization Specialist or Denials/Claims Resolution Specialist.
• Expertise in Credentialing, Provider Enrollment, or Health Plan/Payer Operations.
• Knowledge in Health Information Management or Medical Records administration.