Job Description
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.Education Qualifications:
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