Job Description

Patient Access Coordinator I

The Patient Access Coordinator I plays a critical role in ensuring a smooth and efficient patient experience by obtaining necessary authorizations and referrals and facilitating compliance between patients, payers, and clinical teams. This position requires a detailed-oriented professional who can manage tasks related to front-end revenue cycle operations and clinic functions, ensuring adherence to established policies and procedures.

Essential Functions:

• Obtain and process the appropriate authorizations and referrals from third-party payers to ensure compliance with payer requirements.
• Provide detailed, timely communication to payers and clinical partners regarding benefits, authorizations, and referrals.
• Act as a liaison between patients, clinical teams, and third-party payers to facilitate effective care and resolve any issues related to benefits or authorizations.
• Ensure submission of clean claims and reduction in payer denials by adhering to both organizational and departmental policy and procedures.
• Perform special projects and other duties as needed.
• Assist with special projects by utilizing Excel/Google spreadsheets and communicate results.
• Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.
• Other duties as assigned by the management team.

Periodic Functions:

• Provide coverage for our facilities that do not have a Patient Registration Coordinator (i.e. position open, on PTO, call-ins, etc).
• Verify patient insurance coverage and benefits, ensuring accurate information is obtained and documented.

Essential Qualifications:

Experience Required: This position requires a minimum of 2+ years experience in healthcare third party insurance verification and authorizations.

Education/Licensure/Certification Required: High School Diploma or GED

Education/Licensure/Certification Preferred: CPC or CPC-A, or equivalent

Skills Required: Strong knowledge of insurance policies, CPT and ICD10, payer requirements, and authorization processes. Excellent communication and interpersonal skills, with the ability to interact effectively with patients, payers, and clinical staff. Detail-oriented with strong organizational and problem-solving skills. Strong understanding of and ability to use software and systems, including but not limited to electronic medical record systems, Microsoft Office, and Google Docs/Sheets; daily use of laptop for email, note taking, and other tasks required.

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