Part-Time Administrator - 20195

Role: Part Time Administrator
Priority Location: Global
Working Hours: ~20 hours/week, Pacific Standard Time (PST)
Type of contract: Remote Core Domain: Healthcare/Therapy Insurance Claims, edical Billing & Patient Accounts Receivable
Start Date: As soon as suitable candidates are identified

The final offer is at the client’s discretion and will depend on the candidate’s interview result, skills, and experience. 
 

Role Summary:
We are seeking a highly analytical, process-driven Part-Time Medical Administrator & Claims Specialist to anchor our back-office healthcare insurance, billing, and patient invoicing operations. This role is a specialized administrative seat built for a professional who possesses deep, practical experience navigating the complexities of medical or therapy practice billing, insurance claims filing, and general ledger financial reconciliation.

This is a hands-on operational role requiring absolute data precision and high autonomy. You will serve as the primary gatekeeper for our cash inflow pipelines—proactively tracking claims lifecycles, auditing invoice discrepancies, resolving insurance billing bottlenecks, and ensuring all transactional data maps flawlessly to our financial ledgers.

Key Responsibilities

• 1. Insurance Claims Lifecycles & Discrepancy Auditing
  • Claims Processing & Submission: Prepare, verify, and submit clean insurance claims (including CMS-1500 or equivalent formats) in strict compliance with healthcare regulatory standards (HIPAA) and practice policies.
  • Denial Management & Appeals: Proactively review, track, and systematically appeal denied, rejected, or delayed claims. You will research root causes, gather necessary clinical/administrative documentation, and interface directly with insurance payors to accelerate claim resolutions.
  • Compliance Safeguarding: Stay ahead of policy changes, medical coding updates (ICD-10, CPT), and payer guidelines to minimize submission errors and maintain low rejection rates.
• 2. Patient Invoicing & Full-Cycle Practice Billing
  • Patient Invoicing & Statements: Generate and dispatch highly accurate patient statements, superbills, and invoices based on clinical logs and rendered services.
  • Disbursement Reconciliations: Monitor incoming digital payments, matching insurance Electronic Remittance Advices (ERAs/EOBs), credit card receipts, and patient copays against open Accounts Receivable (AR) ledgers.
  • Collections Coordination: Execute soft collections outreach via email and phone to resolve aging patient balances, past-due invoices, and outstanding copays.
• 3. Financial Administration & Data Hygiene
  • Ledger Synchronization: Maintain pristine records within the practice management and EHR/accounting systems, ensuring that insurance allocations and patient billing data reconcile perfectly with cash positions.
  • Audit-Ready Documentation: Systematically catalog all financial agreements, compliance source files, and insurance correspondence within an organized, HIPAA-compliant cloud infrastructure.
  • Reporting Metrics: Compile routine weekly summaries detailing pending claims volumes, overall aging report statuses, and billing velocity for leadership review.

Required Skills & Qualifications (Must-Haves):

• Major U.S. Payer Experience: Proven hands-on experience navigating and resolving billing claims with major U.S.-based health insurance providers (e.g., Blue Shield, Aetna, Cigna, UnitedHealthcare, Anthem Blue Cross). Direct experience with at least a few of these major payers is required.
• Industry Experience: Minimum 3+ years of direct, hands-on administrative experience working within a healthcare, therapy, or medical practice setting.
• Proven Billing & Claims Expertise: Demonstrated, hands-on experience managing the entire life cycle of insurance claims submission, systematically following up on denials/rejections, and managing patient invoicing/copays.
• The Financial Mindset: Advanced numerical literacy with a deep understanding of standard medical accounting workflows, copay/deductible structures, and balance reconciliation mechanics.
• Technical System Literacy: Strong hands-on proficiency with Electronic Health Records (EHR) / Practice Management software (e.g., SimplePractice, Jane, TherapyNotes, Kareo, etc.), clearinghouses, and cloud productivity software (Advanced Excel/Google Sheets is mandatory).
• The "High-Agency" Operating Style: Exceptional attention to detail. You catch the single digit that is off, you love resolving complex billing puzzles independently, and you carry tasks to completion without micro-management.
• Communication Mastery: Polished verbal and written English communication skills. You must be entirely comfortable negotiating claim outcomes with insurance companies and addressing sensitive billing inquiries with patients/clients professionally.

Success Metrics (KPIs):

• Claims Aging Rate: Maintaining an optimal claims lifecycle velocity by reducing the volume of outstanding or delayed insurance submissions.
• Data Log Accuracy: Zero processing delays or accounting variances resulting from avoidable data-entry mismatches.
• Collections Clean-up: Measurable compression of past-due aging brackets (reducing 60–90+ day outstanding patient and insurance balances).