Healthcare Administrative Specialist
About the Role
A structured healthcare operations initiative is seeking experienced professionals with strong expertise in healthcare administrative and back-office workflows. This opportunity focuses on documenting and supporting the operational processes that enable healthcare organizations to manage patient access, insurance, claims, provider operations, and compliance efficiently.
This opportunity is ideal for professionals currently working in healthcare administration who have extensive experience with revenue cycle management, patient access, payer interactions, or practice operations. Candidates should be comfortable working independently while applying practical knowledge of industry-standard healthcare systems and workflows.
The work involves analyzing and supporting administrative processes across healthcare operations, including patient registration, authorizations, claims management, payment reconciliation, provider administration, and health information management, where operational accuracy and process knowledge are critical.
What You'll Do
- Manage patient registration, scheduling, insurance eligibility verification, and benefits review.
- Coordinate patient intake, referrals, and front-end administrative workflows.
- Initiate, submit, monitor, and follow up on prior authorization requests through payer portals.
- Process healthcare claims, monitor claim status, and resolve claim rejections and denials.
- Prepare and manage appeals while supporting accounts receivable follow-up activities.
- Post electronic remittance advice (ERA) payments and reconcile payments against clinical charges.
- Support provider credentialing, enrollment, and payer administration processes.
- Maintain provider and payer records while assisting with appeals, grievances, and operational requests.
- Administer medical records and release of information procedures in accordance with applicable regulations.
- Maintain accurate documentation while ensuring compliance with healthcare administrative standards.
- Utilize healthcare administrative systems to support daily operational workflows.
Requirements
- Minimum 3 years of hands-on experience in a healthcare administrative or back-office role.
- Current employment in a healthcare administrative position.
- Experience with patient access, revenue cycle management, prior authorizations, medical billing, provider operations, health information management, or related healthcare administrative functions.
- Proficiency using payer portals such as Availity, Optum/Change Healthcare, Waystar, Office Ally, or comparable payer platforms.
- Experience working with electronic health record (EHR), practice management, and healthcare clearinghouse systems.
- Strong understanding of healthcare administrative workflows from patient registration through payment processing.
- Excellent organizational, documentation, and problem-solving skills.
- Ability to work independently in a remote environment while meeting project expectations.
- Must be based in the United States.
- Ability to work as an independent contractor.
- Preferred experience as a Practice Administrator, Medical Office Manager, Revenue Cycle Specialist, RCM Analyst, Medical Billing Coordinator, Patient Access Lead, Referral Coordinator, Prior Authorization Specialist, Claims Resolution Specialist, Credentialing Specialist, Provider Enrollment Specialist, Health Plan Operations Specialist, or Health Information Management professional.
- Familiarity with productivity and AI-assisted tools such as ChatGPT is considered an advantage.