Patient Access Specialist

As a Patient Access Specialist , you will be an essential part of the corporate business support team. You will have the opportunity to collaborate with professionals from diverse backgrounds and contribute to the strategic goals of our company. Your role will involve providing essential support to various departments, enabling them to focus on their core functions and drive overall success. This position reports to the Patient Access Supervisor and is responsible for the accurate and timely verification of insurance coverage and benefits. The PAS is responsible for collecting payments, including copays and coinsurance on the day of the appointment as well as any previous balances on patient accounts.

Key Responsibilities:

• Provides cross functional support to Operations, Front Office, Central Intake, and RCM using technologies available.
• Daily processing of a Batch Eligibility Report for all sites and appointment types; demand eligibility for add on appointments and secondary payers utilizing multiple platforms and technologies.
• Identify eligibility exceptions and resolve the rejection (inactive coverage, demographics, coordination of benefits, etc)
• Obtain new insurance information as needed and enter it accurately into the PM/EHR system. 
• Verify any new coverage benefits and provide appropriate notifications to cross functional teams if any changes in healthcare coverage could impact care; increased patient liability, need for scheduling with a certain provider, transfer of care
• Identify trends in exceptions on the Batch Eligibility Report and open support cases as needed with appropriate vendors, payers, etc.
• Obtain authorizations and reference numbers as required based on the insurance plan presented and the services scheduled.
• Confirm there is a credit card on file for patients with a financial responsibility and contacts them to obtain the information when none is on file
• Processes the appropriate credit card payments for same day appointments and previous balances
• Initiates the financial hardship workflow when necessary and escalates any patient financial issues to the PFS team as needed.
• Demonstrates a thorough knowledge of mental health insurance guidelines and proficiently verifies reads, and understands benefits and communicates financial responsibility to the patients..
• Maintain knowledge of RCM department policies and procedures
• Develop and maintain positive working relationships with cross-functional teams, teammates and Payor representatives and other key stakeholders
• Consistently meet or exceed the department productivity and quality standards and performance requirements
• Collaborate as needed to identify and resolve underpayments and overpayments
• Other duties and responsibilities as assigned including but not limited to:
• Work overtime with little or no notice as needed
• Attend team meetings, phone conferences, and training as needed

Qualifications:

• Minimum 1 year of physician front office or RCM experience
• High school diploma
• Self-starter; able to move own workflow along with minimal oversight
• Accurate; detail oriented and able to meet tight turnaround times
• Strong written, verbal, and interpersonal communication skills 
• Ability to exercise initiative, judgment and decision making skills
• Intermediate computer skills and proficiency in MS word, excel outlook and database management and internet usage
• 2-4 years of physician RCM experience with an emphasis on centralized insurance verification and/or patient access (preferred)
• Ability to have financial discussions with patients (Preferred)

Explore the Advantages of Joining Our Team:

• Enjoy competitive compensation and a wide range of benefits, including medical, dental, vision, low-cost virtual care, dependent and domestic partner coverage, 401K, and more, designed to support your well-being and financial security.
• Immerse yourself in a community united by a deep commitment to enhance mental health and revolutionize patient care.
• Embrace a journey of continuous learning, guided by seasoned professionals, fostering your career growth in a nurturing environment.
• Play a pivotal role in reshaping behavioral health, with your efforts directly improving patient lives.
• Thrive in an environment that celebrates collaborative success, driven by effective communication and unity.
• Receive comprehensive onboarding and ongoing educational resources, tailored to cultivate your talents and assure your triumph in your role.

Transformations Care Network is committed to fair and equitable compensation practices. The hourly compensation range for this role is $20 – $22. Actual compensation may vary based on licensure, experience, market-driven enhancements, and incentive opportunities available for this role. These ranges represent our current standard compensation practices and may be adjusted over time to remain competitive and aligned with organizational needs.

Transformations Care Network is an equal opportunity employer, committed to fostering an inclusive and diverse workplace.

Remote work eligibility: This position is open to candidates across the United States. Based on TCN's current employment requirements, this role is not eligible to be performed in California, Colorado, Connecticut, Delaware, the District of Columbia, Hawaii, Illinois, Maine, Minnesota, Montana, New Jersey, New York, Oregon, or Puerto Rico. Eligible work locations are subject to change.