Senior Patient Access Intake Specialist

19 hours ago


Fall River, Massachusetts, United States Southcoast Health System Full time
Job Title: Senior Patient Access Intake Specialist - Rehab

Southcoast Health System is seeking a highly skilled Senior Patient Access Intake Specialist to join our team in the Rehab department. As a key member of our team, you will be responsible for securing optimal revenue for all services performed at Southcoast Health Rehab Services.

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.
  • Associates degree preferred.
  • Experience in obtaining and processing insurance referrals and authorizations.
  • 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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