Job Opportunities API

Role Overview Operate and document the administrative and operational processes that keep medical practices, hospitals, and health plans running. You will own and execute back-office workflows like patient registration, authorizations, claims lifecycle, payment posting, and provider and payer operations, and you will capture the exact steps these workflows require in the real software and payer portals you use day to day. Key Responsibilities • Actively own one or more core administrative workflows, including but not limited to patient access, prior authorization, claims and revenue cycle, remittance and payment posting, provider and payer operations, and health information administration. • Patient access and front-end duties: registration, scheduling, insurance and eligibility verification, benefits interpretation, patient intake, and referral management. • Prior authorizations and utilization support: initiate, prepare, submit, and track authorizations through payer portals until adjudication. • Claims and revenue cycle tasks: submit claims, track claim status, manage denials and appeals, pursue A/R follow-up, and resolve rejections. • Remittance and payment posting: process electronic remittance advice, post payments, and reconcile payments against clinical charges. • Provider and payer operations: credentialing, provider enrollment, payer configuration, appeals and grievances, and member or provider service interactions. • Health information and practice administration: manage medical records, handle release of information requests, and support day to day office operations. • Document precisely how these workflows are completed in the specific tools and portals you use, including step by step actions, common exceptions, and typical resolution paths. Qualifications • Minimum 3 years of daily, hands on experience in healthcare administrative or back office roles. • Current employment in a healthcare administrative role is required. • Direct, practical experience with the systems that run this work, for example payer portals such as Availity, Optum or Change Healthcare portals, Waystar, Office Ally, or individual payer hubs such as UHC Link, BCBS portals, Aetna portals, plus EHR or practice management systems and clearinghouses. • Practical knowledge of full lifecycle administrative tasks listed above, including authorizations, claims submission and follow up, payment posting, credentialing, and medical records administration. • Ideal backgrounds include, but are not limited to: Practice Administrator, Medical Office Manager, Revenue Cycle Specialist, RCM Analyst, Medical Billing Coordinator, Full Cycle Biller, Patient Access Lead, Intake or Referral Coordinator, Prior Authorization Specialist, Denials or Claims Resolution Specialist, Credentialing or Provider Enrollment Specialist, payer operations roles, or Health Information Management / Medical Records administrator. • This role focuses on administrative and operational workflow expertise, not medical coding or clinical care responsibilities. Work Terms • Location: Remote. • Employment type: Hourly. Compensation • Pay range: 40 - 50 hourly. Eligibility • Candidates must be based in the United States.