Senior Medical Office Administrator (Insurance Authorization Specialist), Bilingual (English/Spanish)

Northwell Health

12d•Onsite

About The Position

FlexStaff is seeking a Senior Medical Office Administrato r with experience in Healthcare Insurance Authorization and Revenue Cycle Operations for our Client, a Prosthetics and Orthotics Lab, located in the Bronx, NY. In this role you will be serving as the lead specialist for insurance verification, benefits investigation, prior authorizations, and re-authorizations using payer portals, electronic systems, and direct payer communication.

Requirements

Advanced knowledge of medical insurance verification, prior authorization processes, and reimbursement methodologies.
Strong understanding of state, federal, and payer-specific regulations related to billing, collections, and compliance.
Bilingual English/Spanish.

Responsibilities

Ensure accurate interpretation of payer-specific medical policies and guidelines.
Validate eligibility, coverage limits, deductibles, and out-of-pocket maximums before service delivery.
Collaborate with clinicians and billing teams to resolve authorization issues and denials.
Monitor authorization turnaround times and escalate delays proactively.
Prepare and oversee timely reporting of key operational metrics.
Maintain organized electronic and physical filing systems for audits and compliance.
Assist with general administrative functions, clerical support, and special projects.
Manage and improve workflows for authorizations, scheduling, and billing.
Develop and implement standardized operating procedures (SOPs) for insurance processes.
Coordinate clinician schedules to align with authorization approvals.
Ensure daily billing readiness by confirming required authorizations and documentation.
Conduct quality audits of administrative and insurance-related work.
Review clinician charts for accuracy and compliance with regulations.
Train and support administrative staff in insurance processes and compliance.
Serve as a resource for complex insurance and administrative issues.
Promote best practices and accountability across operations.