Access Coordinator

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