Patient Access Coordinator

4 weeks ago

Irvine, United States Agendia, Inc. Full time
Job DescriptionJob Description

**Lucrative incentive opportunity

AIM OF THE POSITION:

The Patient Access Coordinator is responsible for requesting authorization for all applicable incoming orders. This process includes understanding of payers’ medical policies for our services, collecting and reviewing all the necessary documentation required to submit prior authorization, contacting the ordering physician or their office for additional information if applicable, completing the required authorization submission forms within allotted timeframes and, follow-up with the payor to obtain an authorization determination. When applicable, the PA Coordinator will also submit a Prior Authorization appeal if criteria is met but the PA was denied erroneously.

POSTION WITHIN THE ORGANIZATION:

1. Customer Care, Sales, Commercial and external vendors

2. Cooperates with all departments across the organization

ESSENTIAL DUTIES AND RESPONSIBILITIES:

  • Reviews incoming orders to determine if authorization is required
  • Reviews documentation from ordering physician for completeness to meet the medical policies of payors and work them in priority dependent on allotted timeframes per payer as the time can vary

. Contacts ordering physician's office to obtain missing documentation when applicable or to meet timeliness of the submissions

  • Communicate with physician offices and/or sales team for assistance with authorization submissions, when applicable
  • Verifies diagnosis code on order in line with current ICD 10 requirements
  • Completion of authorization forms via paper or online
  • Submit authorizations to payors via fax, through payor portal, or third party vendor with all required documentation to maximize success in achieving approvals
  • Log authorization actions within the billing system for tracking
  • Follow up on all open authorization submissions including those submitted by the third party vendor
  • Notify billing staff and document account when authorization determination is received
  • Additional tasks as needed

The above listing represents the general duties considered essential functions of the job and is not to be considered a detailed description of all the work requirements that may be inherent in the position.

KEY CONTACTS:
· Internal: This position may interface with various departments within the company.

· External: Clients and Payors

EDUCATION AND EXPERIENCE REQUIREMENTS:

EDUCATION

Education:

  • High School diploma or general education degree
  • 1 + years related experience preferable

KNOWLEDGE, SKILLS AND ABILITIES (KSA'S)

Specific Knowledge Required:

Knowledge: Comprehension of a body of information acquired by experience or study.

Skill: A present, observable competence to perform a learned activity.

Ability: Competence to perform an observable behavior.

  • Medical Pre-Authorization knowledge/experience 1 + years
  • Knowledge of CPT and ICD 10 codes
  • Previous medical billing experience preferred

· Ability to read and understand medical payer policies as well as pathology reports

  • Ability to work with sensitive and confidential information

BEHAVIOURAL COMPETENCIES/DESIRED SKILLS:

  • Must be able to work in a fast-paced environment
  • Must have strong organizational skills and attention to detail
  • High degree of accuracy
  • Manage Multiple tasks independently
  • Excellent problem resolution
  • Excellent customer service skills
  • "Outside the Box" thinker
  • Other Skills necessary: Analytical thinking, thoroughness, good research skills, and strong verbal/written communication.

· PRIVACY NOTICE: To review the California privacy notice, click here: https://agendia.com/privacy-policy/

· Employees must not be classified as an excluded individual who is prohibited from participation in any Federal health care program.

WORKING ENVIRONMENT:

Establishes ADA (Americans with Disabilities Act) requirements


ENVIRONMENT/SAFETY/WORK CONDITIONS:

Working conditions (inside or outside the office)

  • General office environment. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions
  • Maintains a clean, neat, and orderly work area.
  • Adheres to Department Specific Safety Guidelines.
  • Standing, sitting, walking, bending, reaching, manual manipulation, and lifting up to 15 pounds.

TRAVEL:

No travel is required.

OTHER DUTIES:

Other duties as required by management

 

 

 

Company DescriptionAgendia is the only molecular diagnostics company focused solely on breast cancer. With our groundbreaking genomic testing, we generate reliable and meaningful clinical data about the unique biology of a woman’s breast cancer. Backed by prestigious physicians and institutions globally, we are shifting the standard of care towards more ideal, personalized treatment.Company DescriptionAgendia is the only molecular diagnostics company focused solely on breast cancer. With our groundbreaking genomic testing, we generate reliable and meaningful clinical data about the unique biology of a woman’s breast cancer. Backed by prestigious physicians and institutions globally, we are shifting the standard of care towards more ideal, personalized treatment.

  • Patient Access Coordinator

    2 weeks ago

    Irvine, United States Agendia Full time

    Apply Description AIM OF THE POSITION:The Patient Access Coordinator is responsible for requesting authorization for all applicable incoming orders. This process includes understanding of payers‘ medical policies for our services, collecting and reviewing all the necessary documentation required to submit prior authorization, contacting the...

  • Patient Access Coordinator

    1 week ago

    Irvine, United States Agendia Full time

    Apply Description AIM OF THE POSITION:The Patient Access Coordinator is responsible for requesting authorization for all applicable incoming orders. This process includes understanding of payers‘ medical policies for our services, collecting and reviewing all the necessary documentation required to submit prior authorization, contacting the...

  • Health Data Access Coordinator

    4 weeks ago

    Irvine, California, United States University Of California Irvine Full time

    Job SummaryThe University of California, Irvine (UCI) is seeking a skilled Health Data Access Coordinator to provide support for and coordinate all administrative and operational aspects of health data access and sharing for the University.This role will involve supporting all aspects of health data access requests from initiation through completion of...

  • Patient Care Coordinator

    2 weeks ago

    Irvine, United States Insight Global Full time

    Job DescriptionJob DescriptionRequired Skills and Experience *- 2 years of experience as a Medical Assistant or Care Coordinator- Strong knowledge of medical terminology- Excellent computer skills and communication (comfortable using Outlook, Word, Excel, Chrome, and EMR systems)- Experience with making post-discharge calls- High school diplomaNice to Have...

  • Unit Service Coordinator

    4 weeks ago

    Irvine, California, United States University of California Full time

    About the RoleThe Unit Service Coordinator is a vital member of our nursing team, responsible for coordinating and performing a range of clerical support functions. This includes performing reception duties, collecting and compiling patient data, assembling medical records, and assisting with patient admission and discharge.Key ResponsibilitiesPerform...

  • Patient Care Coordinator

    1 week ago

    Irvine, United States Marque Urgent Care Full time

    Job DescriptionJob DescriptionJoin the Marque Urgent Care family as a Patient Care Coordinator and make a meaningful impact in the healthcare industry! At Marque, we pride ourselves on delivering exceptional, patient-centered care in a welcoming, fast-paced environment. As a Patient Care Coordinator, you’ll be the friendly face that greets patients over...

  • Temporary Coordinator Patient Relations

    1 week ago

    Irvine, United States PDS Health Full time

    Now is the time to join PDS Health. You will have opportunities to learn new skills from our team of experienced professionals. If you're ready to take your career to the next level and gain valuable experience, apply today! The Coordinator, Patient Relations core function entails compiling, processing and sending all patient documentation to insurance plans...

  • Patient Access Representative III

    3 months ago

    Irvine, United States City of Hope National Medical Center Full time

    Join the transformative team at City of Hope, where we're changing lives and making a real difference in the fight against cancer, diabetes, and other life-threatening illnesses. City of Hopes growing national system includes its Los Angeles campus, Patient Access, Representative, Clinic, Patient, Patient Care, Financial, Healthcare

  • Access Representative

    1 month ago

    Irvine, California, United States University Of California Irvine Full time

    Job Summary:We are seeking a highly skilled and detail-oriented Access Representative to join our team at the University of California, Irvine. As an Access Representative, you will serve as the first point of contact for patients in our ambulatory clinics, providing exceptional customer service and ensuring a smooth registration process.Key...

  • Patient Care Coordinator

    2 weeks ago

    Irvine, United States Insight Global Healthcare Full time

    Job DescriptionJob DescriptionAn employer in the area is seeking a Clinical Admin Coordinator. This is a fully remote position but contractor but be in Southern California area. This is an after hours position, working 5pm-1:30am. Day to day responsibilities: Assist with same day anticipated weekend discharges (appts, HH, DME), Repatriate members from...

  • Nurse Navigator

    4 weeks ago

    Irvine, California, United States University Of California Irvine Full time

    Job Summary:UCI Health is seeking a skilled Nurse Navigator to collaborate with medical staff and coordinate high-quality patient care. The ideal candidate will have a strong background in nursing and excellent communication skills.Responsibilities:Coordinate patient care with medical staff and other healthcare professionalsEvaluate services provided and...

  • Infusion Patient Intake Coordinator

    2 months ago

    Irvine, United States LHH Recruitment Solutions Full time

    Job DescriptionJob DescriptionAre you a detail-oriented, compassionate professional looking to make a real impact in healthcare? LHH Recruitment Solutions is hiring a dynamic Client Intake Coordinator to lead the intake process for home infusion and pharmacy services right here in Orange, CA. If you have experience at a fusion clinic, this is your chance to...

  • Associate Patient Care Coordinator Per Diem

    4 weeks ago

    Irvine, California, United States Optum Full time

    At Optum, we strive to deliver care and improve health outcomes by connecting people with the resources they need.The Associate Patient Care Coordinator plays a vital role in our team, providing appointment scheduling, patient registration, and cashiering services.This position is responsible for managing front office support functions, including greeting...

  • Dental Office Coordinator

    1 month ago

    Irvine, California, United States Gentle Dental Full time

    At Gentle Dental, we prioritize our team members' well-being as much as our patients'. Our mission is to deliver exceptional, lifelong oral healthcare services. We enhance our patients' lives by providing accessible, high-quality care, which is essential to overall health and wellbeing. We focus on patient care, operational excellence, personal...

  • Clinical Support Coordinator

    4 weeks ago

    Irvine, California, United States University Of California Irvine Full time

    About the RoleThe Clinical Support Coordinator will be responsible for coordinating and performing a broad range of clerical support functions in the nursing unit. This includes performing reception functions, collecting and compiling patient data, assembling medical records, and assisting with patient admission/discharge. The ideal candidate will have prior...

  • Senior Access Representative

    4 weeks ago

    Irvine, California, United States University Of California Irvine Full time

    Job Summary:The University of California, Irvine is seeking a highly skilled and customer-focused individual to serve as a Senior Access Representative. This role is responsible for providing exceptional customer service to patients calling to obtain medical services at UC Irvine Medical Center.Key Responsibilities:Provide high-quality customer service to...

  • Treatment Coordinator

    3 months ago

    Irvine, United States Gentle Dental Full time

    At Gentle Dental, we value our teammate’s smile as much as our patient’s smile.  Our vision is to provide exceptional, lifelong, integrated oral healthcare services. We enhance the quality of our patients’ lives by providing accessible oral healthcare, which is paramount to overall health and wellbeing.   We focus on a commitment to patient care,...

  • Nurse Navigator

    4 weeks ago

    Irvine, California, United States University of California Full time

    About the RoleAs a Nurse Navigator in the Urology Clinic, you will provide exceptional patient care and coordination services to patients with complicated medical diagnoses. Your expertise will ensure seamless communication between patients, physicians, and the healthcare team. Key ResponsibilitiesProvide nursing care to patients in the outpatient Urology...

  • Associate Patient Care Coordinator Per Diem

    2 months ago

    Irvine, United States UnitedHealth Group Full time

    Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion,...

  • Unit Service Coordinator

    1 month ago

    Irvine, California, United States University of California Full time

    About the Role As a Unit Service Coordinator at the University of California, Irvine, you will play a vital role in ensuring the smooth operation of our nursing units. Your primary responsibility will be to coordinate and perform a broad range of clerical support functions, including reception duties, collecting and compiling patient data, assembling medical...