Managed Care Administrative Specialist

AgeSpan•Lawrence, MA

About The Position

The Managed Care Administrative Specialist provides specialized administrative and operational support to AgeSpan’s Managed Care Department. The role focuses on service authorizations, enrollment activities, billing denials, data integrity, and communications with internal and external partners. The position is 37.5 hours per week. The stated pay range is $24.00–$27.00 per hour; actual pay depends on factors including internal equity, experience, and qualifications. AgeSpan describes its workplace as supportive, collaborative, innovative, and committed to diverse perspectives, employee development, and work-life balance. Depending on the role and hours, the agency offers flexible scheduling and hybrid work opportunities.

Requirements

Associate degree and two years of administrative support experience required; a high school diploma and at least five years of administrative experience may be considered instead.
Proficiency in Office 365 and 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 is preferred.
Prior experience with large client databases is a plus.

Responsibilities

Coordinate provider referrals through the service procurement process, confirm service start dates, notify the Geriatric Support Services Coordinator (GSSC), and enter service 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 for accurate 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 to A&D using the monthly enrollment roster.
Collaborate with internal teams, providers, and external partners to maintain accurate records, support service transitions, and follow organizational policies and procedures.
Maintain Elira reports and review and clean up data to ensure accuracy and integrity in 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 issues, reduce claim denials, and improve billing accuracy.
Support management in 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, mailings, and other materials, 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.