Access Coordinator

Access Coordinator

The Access Coordinator gathers necessary insurance information and uses expertise to translate the information provided by the patient/guarantor into the computer system, resulting in accurate claim submissions.

Key Responsibilities:

• Prepares and submits payer-specific prior authorizations and referrals in alignment with relevant guidelines and medical policy criteria
• Accurately identifies required insurance verification and medical documentation in accordance with payer policy
• Collaborates with clinicians and medical practitioners to obtain all necessary information for successful authorization approval
• Thoroughly documents all interactions and actions related to insurance processes within the electronic Medical Record (EMR) system
• Regularly reviews and monitors assigned work queues, identifying, and focusing on accounts with the highest financial reimbursement risk
• Adapts to urgent clinical needs while maintaining high-quality work outputs within specified timelines
• Communicates with patients as needed to facilitate medical clearance
• Develops pre-service estimates and supports pre-service collections
• Supports the review of prior authorization requests that do not initially meet criteria and works collaboratively with relevant stakeholders to resolve issues or coordinate necessary clinician-to-health plan interventions

Required Qualifications:

• 1 year of relatable healthcare experience

Preferred Qualifications:

• Healthcare experience within patient care, registration, scheduling, pre-certifications/prior authorizations, collections, and medical terminology

FTE: 1

Possible Remote/Hybrid Option: Remote

Shift Rotation: Day Rotation (United States of America)

Shift Start Time: 8:00am

Shift End Time: 4:30Pm

Weekends: NO

Holidays: No

Call Obligation: No

Union: DC USWA Main & Neighborhoods (DCUMN)

Compensation Range: $20.20 - $30.09

Employee Benefits at Essentia Health:At Essentia Health, we're committed to supporting your well-being, growth, and work-life balance. Our comprehensive benefits include medical, dental, vision, life, and disability insurance, along with supplemental options to fit your needs. We offer a 401(k) plan with employer contributions to help you plan for the future, and we invest in your professional development through training, tuition reimbursement, and educational programs. To help you thrive both at work and at home, we provide flexible scheduling, generous time off, and wellness resources focused on your physical, mental, and emotional health. Please note that benefit eligibility may vary. For full details, refer to your benefit summary or contact our HR Service Center at View phone number on click.appcast.io.

It is our policy to afford EEO to all individuals, regardless of race, religion, color, sex, pregnancy, gender identity, national origin, age, disability, family medical history, genetic information, sexual orientation, marital status, military service or veteran status, culture, socio-economic status, status with regard to public assistance, and other factors not related to qualifications, including employees or applicants who inquire about, discuss, or disclose their compensation or the compensation of other employees or applicants, or membership or activity in a local human rights commission, or any other category as defined by law.