Patient Access Coordinator

Description


PATIENT ACCESS COORDINATOR I

Job Description

New Season


Employee Name: Reports to: Patients Access Supervisor Job Code:

Department: Revenue Cycle Management FLSA: Non-Exempt Direct Reports: 0


Job Summary:


The Patient Access Coordinator I plays a critical role in ensuring a smooth and efficient patient experience by obtaining necessary authorizations and referrals and facilitating compliance between patients, payers, and clinical teams. This position requires a detailed-oriented professional who can manage tasks related to front-end revenue cycle operations and clinic functions, ens uring adherence to established policies and procedures.


Essential Functions:


• Obtain and process the appropriate authorizations and referrals from third-party payers to ensure compliance with payer requirements.

• Provide detailed, timely communication to payers and clinical partners regarding benefits, authorizations, and referrals.

• Act as a liaison between patients, clinical teams, and third-party payers to facilitate effective care and resolve any issues related to benefits or authorizations.

• Ensure submission of clean claims and reduction in payer denials by adhering to both organizational and departmental policy and procedures.

• Perform special projects and other duties as needed. Assist with special projects by utilizing Excel/Google spreadsheets and communicate results.

• Use, protect and disclose patients' protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.

• Other duties as assigned by the management team.


Periodic Functions:


• Provide coverage for our facilities that do not have a Patient Registration Coordinator (i.e. position open, on PTO, call-ins, etc).

• Verify patient insurance coverage and benefits, ensuring accurate information is obtained and documented.


Essential Qualifications:


Experience Required:

This position requires a minimum of 2+ years experience in healthcare third party insurance verification and authorizations.


Education/Licensure/Certification Required:

• High School Diploma or GED


Education/Licensure/Certification Preferred:

• CPC or CPC-A, or equivalent


Skills Required:

• Strong knowledge of insurance policies, CPT and ICD10, payer requirements, and authorization processes.

• Excellent communication and interpersonal skills, with the ability to interact effectively with patients, payers, and clinical staff.

• Detail-oriented with strong organizational and problem-solving skills.

• Strong understanding of and ability to use software and systems, including but not limited to electronic medical record systems, Microsoft Office, and Google Docs/Sheets; daily use of laptop for email, note taking, and other tasks required.


Job or State Requirements

HS Diploma or GED, This position requires a minimum of 2+ years experience in healthcare third party insurance verification and authorizations.