Medical Administrative Assistant

EDGE is connecting top global talent with the US healthcare and insurance industry, aiming to build a borderless network centered around people. We are seeking a Medical Administrative Assistant to support US-based healthcare providers. The ideal candidate will have hands-on experience in the US healthcare environment, including scheduling, eligibility verification, prior authorizations, and insurance verification. This role is vital in facilitating communication between patients, healthcare providers, and insurance companies, requiring a detail-oriented and tech-savvy professional who can efficiently manage insurance portals and electronic health records to ensure timely patient care.

Key Responsibilities
- Conduct thorough eligibility checks and benefits verification for patients before their appointments.
- Interpret complex insurance policies, distinguishing between PPO, HMO, Medicare, and Medicaid guidelines.
- Determine patient financial responsibilities such as deductibles, copays, and coinsurance, and accurately document these in the practice management system.
- Prepare, compile, and submit prior authorization requests through various channels including web portals, fax, and phone.
- Review clinical documentation like progress notes, lab results, and physician orders to confirm medical necessity before submission.
- Monitor the status of pending authorizations, manage appeals for denied claims, and expedite urgent requests to avoid delays in patient care.
- Manage inbound and outbound patient calls to schedule, reschedule, and remind them of wellness visits and routine check-ups.

Required Qualifications
- Minimum of one year of direct experience in the US healthcare industry, specifically in scheduling, eligibility verification, prior authorizations, and insurance verification.
- Strong understanding of US insurance concepts including PPO, HMO, Explanation of Benefits (EOBs), copays, and patient benefits eligibility.
- Proficiency in navigating insurance portals such as Availity, Optum, and CoverMyMeds, as well as electronic health record/practice management systems like ECW, Tebra, or Dentrix.
- Exceptional attention to detail, strong analytical skills, and excellent written and verbal communication in English.
- Ability to work independently in a fast-paced environment.

Preferred Qualifications and Benefits
While specific preferred qualifications and benefits are not explicitly listed, candidates who demonstrate adaptability, strong interpersonal skills, and a commitment to patient-centered service will thrive in this role. Joining EDGE means becoming part of a global talent network that values diversity, inclusion, and professional growth.

Our Hiring Process
Applicants will undergo a thorough review of their application and resume. Selected candidates will be invited to an interview with an EDGE representative to assess fit and alignment with the role. Successful candidates will then complete onboarding and training before participating in client interviews tailored to specific healthcare provider needs. Once matched, candidates join the EDGE Global Talent Community, ready to contribute meaningfully to healthcare.

EDGE is committed to creating a diverse and inclusive workplace. We are proud to be an equal opportunity employer, ensuring all qualified applicants receive fair consideration regardless of race, color, religion, gender identity or expression, sexual orientation, national origin, disability, age, veteran status, or any other protected status.

Join EDGE and become part of a mission-driven organization that removes geographic barriers to employment and connects exceptional talent with meaningful opportunities in the US healthcare sector.