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Patient Access Coordinator

2 months ago

Blue Ridge, Georgia, United States PruittHealth Full time
Job Summary

PruittHealth is seeking a highly skilled and detail-oriented Patient Access Coordinator to join our team. As a Patient Access Coordinator, you will play a critical role in facilitating the conversion of referrals to admissions through the completion of the intake process and the use of effective phone and customer service skills.

Key Responsibilities
  • Complete financial clearance for all referrals by determining eligibility.
  • Process referrals to assure pre-qualifying of patients efficiently.
  • Verify all primary and secondary insurance information for all incoming patients to include service coverage, benefit maximums and limitations, co-insurance/co-payment, pre-existing clause, coverage, and provider network status.
  • Determine effective and termination dates, type of plan, and provider network status.
  • Complete all information with attention to timely filing dates and special filing requirements.
  • Analyze admission data and prepare assigned reports.
  • Load all patient demographic insurance and benefit information into appropriate software systems.
  • Communicate effectively with referral sources and team members to support business partnerships being developed by the sales team.
  • Establish positive relationships with insurers and managed care entities; third-party payors and case managers.
  • Obtain complete and accurate information to facilitate the admissions process and to maximize the likelihood of reimbursement.
  • Utilize reports to assure accurate and timely information is documented in the appropriate software system.
Requirements
  • Associate's Degree preferred.
  • 2+ years of experience in a related field.
  • Proficient in Microsoft Office, Word, and Excel.
  • Understanding of patient compliance issues, Medicare, Medicaid, and Commercial Insurance.
  • Excellent communication skills and customer service.
  • Familiarity with Medical Terminology.
  • Experience working in a call center environment.
  • Ability to multi-task, problem solve, and demonstrate critical thinking skills.