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

Northwell Health•Lake Success, NY

14h•Onsite

About The Position

FlexStaff is seeking a Senior Medical Office Administrator with experience in Healthcare Insurance Authorization and Revenue Cycle Operations for our Client, a Prosthetics and Orthotics Lab, located in Manhattan, 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

High school diploma or equivalent required.
Advanced knowledge of medical insurance verification, prior authorization processes, and reimbursement methodologies.
Prior experience in healthcare billing, collections, or revenue cycle operations required.
Bilingual English/Spanish.

Responsibilities

Lead insurance verification, benefits investigation, prior authorizations/re-authorizations.
Interpret payer policies, coverage criteria, and reimbursement rules.
Validate eligibility, deductibles, co-insurance, and OOP maximums before services.
Resolve authorization issues and denials with clinicians and billing.
Track turnaround times and escalate delays; report key metrics.
Maintain organized filing for audits and compliance.
Optimize workflows for authorizations, scheduling, documentation, and billing readiness.
Create and maintain SOPs; coordinate clinician schedules with authorizations.
Ensure daily billing readiness; use practice management systems to track status.
Audit authorization accuracy, documentation completeness, and billing readiness.
Identify trends and gaps; recommend corrective actions.
Ensure compliance with payer, state, and federal regulations; retrain staff as needed.
Train and supervise administrative staff on insurance processes and standards.
Act as escalation point for complex issues and promote best practices.