Healthcare Administrative Workflow Specialist (Availity)

About the Role

We're looking for professionals with deep, hands-on experience navigating healthcare administrative workflows within Availity Essentials and other major payer portal applications. You'll help us understand the precise steps required to complete insurance-related tasks, resolve data discrepancies, and manage end-to-end administrative processes.

Core Workflows

You should actively manage and complete one or more of the following:

• Eligibility & Benefits: Verifying active coverage, determining patient cost-shares (copays/deductibles), and interpreting plan-specific limitations
• Claims Management: Full lifecycle of a claim — submission, status tracking, and resolution of rejections or denials
• Prior Authorizations: End-to-end authorization process, from initial request submission to tracking approvals within Payer Spaces
• Remittance & Payment Posting: Handling electronic remittance advice (ERA) and reconciling payments against clinical charges

Requirements

• 2+ years of daily, hands-on experience with Availity Essentials or similar payer portals (Optum/Change Healthcare, Waystar, Office Ally, or individual payer hubs like UHC Link, BCBS, Aetna)
• Currently working in a healthcare administrative role
• Experience with Revenue Cycle, Payer Portals, or Clearinghouse Management
• Based in the United States

Ideal Backgrounds

• Practice Administrator / Medical Office Manager
• Revenue Cycle Specialist / RCM Analyst
• Medical Billing Coordinator / Full-Cycle Biller
• Patient Access Lead / Intake Coordinator
• Claims Resolution Specialist

Note: We are specifically looking for administrative workflow expertise — not medical coding or clinical roles.