US Medical Admin: Eligibility, Scheduling & Prior Auth Pro

Edge; Pakistan; À distance; PKR 10 526 000 - 14 404 000; Plein temps

Résumé du poste

Edge is seeking a Medical Administrative Assistant to support US-based healthcare providers. You will verify eligibility, determine patient financials, and submit prior authorizations while navigating portals and EHR systems. This role acts as a liaison between patients, providers, and insurers to ensure timely access to care.

The ideal candidate has 1+ year US healthcare experience, strong English communication, and meticulous attention to detail to work effectively in a fast-paced environment.

Qualifications

• 1+ year of direct experience in US healthcare scheduling and eligibility.
• Deep understanding of PPO, HMO, EOBs and patient benefits.
• Experience navigating insurance portals (Availity, Optum, CoverMyMed s).
• Proficient in electronic health record/practice management systems (ECW, Tebra, Dentrix).
• Excellent written and verbal English communication; detail oriented.

Responsabilités

• Conduct eligibility checking and benefits verification.
• Interpret insurance policies (PPO/HMO/Medicare/Medicaid).
• Document patient financial responsibilities in the PM/EMR system.
• Prepare and submit prior authorization requests via portals, fax, or phone.
• Review clinical docs to ensure medical necessity before submission.
• Track authorization status and manage appeals for denials.
• Handle inbound/outbound calls to schedule and remind patients.

Connaissances

English communication

Attention to detail

Customer service

Independent work

Fast-paced environment

Outils

Availity

Optum

CoverMyMed s

ECW

Tebra

Dentrix

Description du poste

Edge is seeking a Medical Administrative Assistant to support US-based healthcare providers. You will verify eligibility, determine patient financials, and submit prior authorizations while navigating portals and EHR systems. This role acts as a liaison between patients, providers, and insurers to ensure timely access to care.

The ideal candidate has 1+ year US healthcare experience, strong English communication, and meticulous attention to detail to work effectively in a fast-paced environment.