Access Coordinator | Certified Healthcare Access Associate (CHAA)

Access Coordinator | Certified Healthcare Access Associate (CHAA)

Linden, NC $41,089 - $52,099 a year

Full Time

Join a dedicated healthcare team as an Access Coordinator, where you will play a vital role in managing patient referrals and ensuring smooth clinical and financial clearance. This full-time day position involves verifying demographic, clinical, financial, and insurance information, as well as validating medical necessity for Medicare and non-Medicare cases. You will be responsible for processing signed physician orders and referrals, maintaining accurate clinical documentation, and coordinating specialty and outpatient ancillary referrals.

Key Responsibilities:

• Maintain comprehensive knowledge of referral processes and medical administrative procedures, including handling protected patient information.
• Perform insurance eligibility and benefit verification using various tools, ensuring authorizations align with requested services.
• Validate medical necessity through LMRP/LCD reviews to guarantee clinical and financial clearance.
• Obtain specialist contact details, print orders and patient demographics, and document appropriately in the electronic health record (EHR).
• Determine referral requirements and limitations, including emergent referrals.
• Pre-register patients for upcoming visits and communicate referral approvals or denials to patients and guarantors.
• Confirm appointments with referring offices and patients, providing necessary preparation instructions.
• Complete follow-up protocols for routine and urgent referrals as directed by leadership.
• Assist insurance companies, physicians, and hospital departments with patient information in compliance with HIPAA guidelines.
• Meet or exceed accuracy standards set by Patient Access Leadership.

Education and Experience:

• Registered or Certified Medical Office Assistant, or 2-4 years of direct referral experience in lieu of certification.
• Licensed Practical Nurse background preferred.
• Medical terminology knowledge required.
• 2-4 years of insurance/referral experience in a hospital or medical office setting preferred.

Skills and Abilities:

• Successful completion of pre-employment and post-training testing.
• Pass and maintain Certified Healthcare Access Associate (CHAA) certification within one year of employment.
• Strong knowledge of insurance processes and payment collection.
• Proficiency with Microsoft software.
• Excellent verbal and written communication, customer service, and problem-solving skills.
• Ability to manage complexity and stress while adapting to changing patient and organizational needs.
• Flexibility to work department hours, including possible shift rotations.

Physical Requirements:

• Effective oral communication and sensory abilities to collect information.
• Dexterity to operate office equipment and extensive computer use.
• Ability to lift and move files and materials up to 50 pounds occasionally.
• Work environment noise level is low to moderate.

This role is based in a regional healthcare setting serving the Southeastern United States, offering a collaborative and patient-centered work environment.