We are seeking a highly skilled, efficient, and resilient Bilingual Medical Administrative Assistant to support a fast-paced, high-volume U.S. healthcare practice. This role demands a unique combination of exceptional patient customer service and deep revenue cycle competency, with a sharp focus on handling complex HMO and insurance authorizations.
The ideal candidate must comfortably navigate a tech-forward environment, utilizing advanced platforms like AthenaHealth, Weave, and AI-integrated communication portals.
Primary Responsibilities:
Prior Authorization & Insurance Management:
- HMO Prior Authorizations: Submit, track, and secure complex prior authorizations for HMO cases, ensuring all clinical documentation meets payer criteria.
- Visit Mapping: Electronically attach approved authorizations and referral codes directly to patient visits within AthenaHealth to guarantee clean claim submissions.
- Insurance Verification: Conduct rigorous eligibility and benefit verifications across Medicare, Medicaid, HMOs, and PPOs prior to patient appointments.
High-Volume Patient Communications & Technology Integration:
- Call Management: Handle high-volume inbound and outbound patient calls efficiently while maintaining a professional, reassuring demeanor.
- AI Portal Syncing: Monitor and manage patient interactions via the Yobi AI receptionist portal, ensuring seamless handoffs between automated workflows and live care.
- Appointment Management: Utilize Weave to handle multi-channel communication, text reminders, and real-time appointment scheduling/rescheduling.
- Patient Retention Outreach: Execute targeted outbound campaigns for no-show follow-ups and proactively contact patients to retrieve missing demographic data or insurance ID cards.
Requirements
- Required Qualifications (Non-Negotiable)
- Experience: Minimum of 4+ years of verified administrative or receptionist experience supporting a U.S.-based healthcare practice.
- EMR Expertise: Extensive, hands-on administrative proficiency within AthenaHealth EMR (AthenaOne).
- Tech Stack Familiarity: Direct experience working with Weave (or equivalent VoIP appointment platforms) and digital communication hubs.
- Workflow Agility: Proven capability to maintain high accuracy and a calm demeanor in a high-call-volume clinic environment.
- Workspace Setup: A dedicated, quiet home office with high-speed internet, a noise-canceling headset, and reliable power backup.
- Preferred Qualifications
- Insurance Literacy: Deep familiarity with major U.S. insurances, regional HMOs, and IPAs (e.g., Regal, Optum, IEHP, PPOs, Medicare, and Medicaid).
- Specialization: Prior dedicated experience working as an Authorization/Billing Specialist or a Medical Front Desk Lead.
