Access Coordinator

Job Description 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. May be responsible for some or all of the following: insurance verification, ICD 10 or HCPC code selection, prior authorization, pre‑certification, medical necessity determination, referrals, workers compensation authorization, service estimates, patient communication when services are not covered, pre‑service collections. 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. #J-18808-Ljbffr