Senior Patient Access Coordinator

4 weeks ago


Fall River, Massachusetts, United States Southcoast Health System Full time
About the Role

We are seeking a highly skilled Sr. Patient Access Intake Specialist to join our team at Southcoast Health System. As a key member of our operations team, you will play a critical role in securing optimal revenue for our services and ensuring seamless patient care.

Key Responsibilities
  • Determine patient liability prior to service by creating an estimate based on individual payer, notifies patient of their potential liability in accordance with the Federal and State regulations.
  • Initiate contact with patients, clinicians, and third-party payers to obtain pre-certification and authorization for evaluations and diagnostic tests.
  • Use critical thinking skills to ensure CPT codes are documented and authorized for the appropriate service.
  • Navigate multiple payer portals to determine requirements for authorization and submit electronic requests.
  • Follow up with payer denials by researching clinical data to support an appeal.
  • Verify coverage and initiate authorizations for new evaluations and treatments.
Requirements
  • Equal to completion of four years of high school plus additional specialized courses or training, secretarial school, diploma, or medical office certification.
  • Duties require comprehensive understanding of medical terminology and managed care plans and experience in obtaining and processing insurance referrals and authorizations.
  • Knowledge of Healthcare and Managed Care preferred.
  • Proficient keyboarding skills are essential.
  • Must possess strong reasoning and critical thinking skills.
  • Proficient in use of software applications such as e-mail, Work, Excel, EHR.
  • Exceptional customer service skills are required.
  • Over three years of related medical office work experience is required.
  • Experience in obtaining and processing insurance referrals and authorizations. Knowledge of Healthcare and Managed Care preferred.
  • Must be fully vaccinated against seasonal Influenza and the COVID-19 virus or to be exempt from the requirement for medical or personal reasons by signing a statement certifying you are choosing to be exempt from vaccination once hired.
What We Offer
  • A culture of well-being that embraces, respects, and celebrates the rich diversity of one another and the communities we serve.
  • Competitive pay and comprehensive benefits package.
  • Generous Earned Time Off Package.
  • Employee Wellbeing Program.
  • 403B Retirement Plan with company match.
  • Tuition assistance / Federal Loan Forgiveness programs.
  • Professional growth opportunities and customized leadership training.


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