Patient Access Specialist

Patient Access Specialist

Location: Wilmington, NC-New Hanover County

Required Educational/Experiential Qualifications

• High school diploma or GED with 2-3 years experience related to responsibilities specified.
• Knowledge of electronic health care systems, clinical documentation, and standards.
• Familiar with DSM and ICD-10 codes
• Previous experience with identifying insurance benefits and collecting payments
• Knowledge of state funded terminology
• Basic computer skills including Excel
• Strong organizational, problem solving and analytical skills.
• Working knowledge of cash management principles and/or procedures.

General Statement Of Duties

The Patient Access Specialist is responsible for reviewing and verifying client demographic and financial information prior to intake. Responsible for preparing financial agreement, based on information obtained from private insurer, and obtaining client signature. Responsible for coordinating client with appropriate clinician based on client's funding and clinician availability. Responsible for tracking and submitting authorizations accurately and efficiently to ensure all rendered services are authorized within contractual guidelines and billable.

Essential Duties And Tasks

• Review client intake paperwork including insurance information to determine mental health benefits; if client is uninsured, determine eligibility for state funding.
• Prepare financial agreements and obtain client signatures.
• Schedule intake appointments with the appropriate clinician.
• Submit enrollments and updates to MCOs.
• Monitor client's utilization of unmanaged units and notify clinicians when authorization for continued services is needed.
• Review clinical documentation for completeness and submit to MCO for authorization requests.
• Follow up with MCO to determine approval or denial of authorization requests in a timely manner and effectively communicate with clinician.
• Work directly with MCO and private insurances.
• Excellent interpersonal and communication skills, possesses experience and competency in customer relation skills.
• Ability to organize and prioritize work in a stressful environment.
• Encourages teamwork; energetic, and motivates team and individuals.
• Maintains a cooperative work environment to foster Coastal Horizons Center's missions and values to meet goals.
• Proficient with MS Office.
• Performs miscellaneous job-related duties as assigned.
• Must be able to perform sedentary work exerting up to ten (10) pounds of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects.
• Must possess the visual acuity to prepare and analyze data and figures and operate computer terminal.

Salary & Benefits

• Competitive salary based on experience
• Comprehensive medical, dental, and vision insurance
• Educational loan repayment programs & Career growth
• Retirement savings plan/401K
• Paid time off programs, rollover hours, 14 paid holidays
• Employee engagement activities, resource groups, and diversity events

Request For Accommodations

If you require an accommodation during the application process, please contact us at View email address on click.appcast.io.

We look forward to reviewing your application!

EEO Statement

Coastal Horizons is an Equal Employment Opportunity (EEO) employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sexual orientation, gender, gender identity and expression, national origin, age, disability or protected veteran status. We celebrate diversity and are committed to creating an inclusive environment for all of our associates.