Patient Access Representative - Admitting

Job Description

We are seeking a highly organized and detail-oriented Admissions-Patient Access Representative to join our team. This role is responsible for scheduling patients, ensuring the accuracy of insurance verification, eligibility, benefits, and facilitating a smooth billing process. The successful candidate will be a key player in coordinating with insurance companies for prior authorizations, preparing cost estimates, managing payment collections at the time of service, and submitting medical records for clinical review. The ideal candidate will have strong communication skills, able to multi-task and work productively in a team environment.

Qualifications

• High School Diploma or equivalent (required)
• Previous experience utilizing EPIC EMR, insurance verification, patient access, or a healthcare-related field is preferred
• Knowledge of insurance terminology, plans, and billing processes
• Strong attention to detail and organizational skills
• Excellent communication and interpersonal skills, both written and verbal
• Ability to manage multiple tasks and work in a fast-paced environment
• Proficient with Microsoft Office Suite
• Scheduling Patients
• Verify insurance benefits and eligibility to ensure accurate billing and claims submission
• Contact insurance companies to obtain prior authorizations for medical procedures and surgeries before patient visits
• Review and prepare cost estimates to ensure accurate collections at the time of service
• Submit requested medical records to insurance companies for clinical reviews, ensuring compliance with privacy and regulatory standards
• Work with healthcare providers to resolve insurance-related issues and ensure timely claim processing
• Maintain up-to-date knowledge of insurance plans, billing guidelines, and procedures to ensure accurate and compliant practices
• Track and follow up on outstanding authorizations, benefits verification, and other insurance-related inquiries to ensure the timely resolution of issues
• Communicate effectively with patients, insurance representatives, and internal staff to resolve billing or authorization issues promptl.
• Assist with any other duties related to insurance verification and billing as needed