Managed Care Administrative Specialist

AgeSpan•Lawrence, MA

3d•$24 - $27

About The Position

AgeSpan is hiring a Managed Care Administrative Specialist to provide specialized administrative and operational support to the Managed Care Department, particularly in service authorizations, enrollment activities, billing denials, data integrity, and communications with internal and external partners. The role involves maintaining accurate member records and database information, supporting service transitions, resolving billing-related issues, and assisting with administrative materials and projects. The position is 37.5 hours per week. AgeSpan describes its work environment as supportive, collaborative, innovative, and committed to diverse perspectives, employee development, and work-life balance. Flexible scheduling and hybrid work opportunities may be available depending on the role and hours.

Requirements

Associate degree and two years of administrative support experience; a high school diploma and at least five years of administrative experience may be considered instead.
Proficiency in Office 365.
Ability to master new procedures with minimal oversight.
Strong interpersonal and organizational skills.
Critical thinking and attention to detail.
Ability to prioritize, multitask, and work well in a fast-paced team environment.
Ability to work independently and collaboratively.

Nice To Haves

Administrative experience in medical billing or healthcare prior authorization processing.
Prior experience with large client databases.

Responsibilities

Oversee and complete service authorizations by coordinating provider referrals through the service procurement process, confirming service start dates, notifying the Geriatric Support Services Coordinator (GSSC), and entering authorizations into the Aging & Disability (A&D) database (WellSky).
Ensure timely communication with members through the GSSC.
Process enrollment transfers by entering data in A&D, notifying the GSSC or Home Care and Care Manager, and reviewing the final enrollment roster to verify system updates.
Manage disenrollment closures by completing documentation, notifying providers of service closures, coordinating with the GSSC, and sending communications to the health plan as needed.
Coordinate Consumer Directed Care (CDC) to Personal Care Attendant (PCA) transfers with the PCA Team, verify transfer dates, update A&D, and use PCA Partner when applicable.
Add new member enrollments into A&D from the monthly enrollment roster, ensuring accurate and timely data entry.
Collaborate with internal teams, providers, and external partners to maintain accurate records, facilitate service transitions, and comply with organizational policies and procedures.
Maintain Elira reports and conduct ongoing data review and cleanup to ensure accuracy and integrity within the A&D database.
Review membership rosters and reconcile A&D data to maintain accurate member records.
Complete monthly assessment billing and submit documentation to the manager for review and approval.
Work with the Fiscal Department to identify and resolve service authorization-related issues, reduce claim denials, and improve billing accuracy.
Support management with creating, maintaining, and updating digital and paper forms, documents, and other administrative materials.
Upload required documentation and accurately record member-related activities in the A&D database.
Prepare member packets and mailings, and provide administrative support for recurring and special projects.
Participate in required trainings, departmental meetings, and agency-wide meetings.
Perform other related duties and responsibilities as assigned.