Senior Patient Access Coordinator
2 days ago
Southcoast Health is a not-for-profit, charitable health system with multiple hospitals, clinics, and facilities throughout Southeastern Massachusetts and Rhode Island. We are committed to providing inclusive, ethical workplaces where our highly skilled caregivers offer world-class, comprehensive healthcare close to home.
We are seeking a talented Sr. Patient Access Intake Representative (Rehab) to join our team. This role will be responsible for securing optimal revenue for all services performed at Southcoast Health Rehabilitation Services. The successful candidate will determine patient liability prior to service, create estimates based on individual payer, and notify patients of their potential liability in accordance with Federal and State regulations.
The ideal candidate will possess strong reasoning and critical thinking skills, as well as proficiency in software applications such as email, Work, Excel, and EHR. Exceptional customer service skills are required, and over three years of related medical office work experience is preferred.
As a member of our team, you will enjoy a competitive pay and comprehensive benefits package, including a generous Earned Time Off Package and Employee Wellbeing Program. You will also have opportunities for professional growth and customized leadership training.
Southcoast Health is an Equal Opportunity Employer.
Responsibilities- Determine patient liability prior to service by creating an estimate based on individual payer and notifying patients of their potential liability in accordance with 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.
- 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 email, 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.
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