Access Specialist | Patient Access Representative

3 days ago

Greenwich, KS, United States MLee Healthcare Staffing and Recruiting, Inc Full time

Join a compassionate healthcare team in the Midwest region as a Patient Access Representative, where your role is vital in ensuring smooth patient intake and insurance verification processes. You will be responsible for identifying insurance coverage, obtaining necessary pre-certifications, and assisting with referral data entry to support positive patient and agency outcomes.

Essential Functions

  • Verify insurance eligibility and benefits accurately.
  • Obtain pre-certifications and ongoing authorizations from various insurance providers.
  • Assist with intake and referral processes, ensuring timely responses to patient needs and optimal staffing utilization.
  • Maintain up-to-date knowledge of federal, state, and private reimbursement regulations, including CMS guidelines.
  • Participate in insurance and regulatory audits and data submissions.
  • Facilitate compliance with certification, PPOC, and Face to Face requirements.
  • Audit admissions and patient records for program-specific conditions and quality reporting.
  • Complete pre-billing and performance improvement chart audits as assigned.
  • Document accurately and timely according to agency policies.
  • Promote effective communication and cooperation with physicians, staff, and clients to ensure reimbursement success.
  • Support billing processes including generation and transmission of notices of election and admission.
  • Perform clerical duties such as managing phone calls and processing incoming faxes.
  • Adhere strictly to HIPAA privacy and security regulations regarding Protected Health Information (PHI).
Minimum Knowledge and Skills
  • Advanced computer skills with proficiency in medical record systems.
  • Effective communication abilities.
  • Intermediate knowledge of Microsoft Office suite.
  • Strong keyboarding, filing, data processing, and general office skills.
Preferred Behavioral Skills
  • Integrity: Demonstrates honesty and a commitment to ethical behavior.
  • Compassion: Exhibits empathy and excellent customer service.
  • Accountability: Takes ownership of projects and adapts flexibly to changing priorities.
  • Respect: Collaborates effectively with diverse populations and maintains a positive service orientation.
  • Excellence: Communicates clearly and upholds high standards in service delivery.
Education and Experience
  • Minimum: High School Diploma.
  • Preferred: Associate's or Bachelor's Degree in Health Care or Business.
  • Preferred experience includes medical terminology, medical office work, and insurance authorization.
Licenses and Certifications
  • Required: Valid driver's license and proof of auto liability insurance.

This role offers competitive pay and a generous benefits package, providing a meaningful opportunity to contribute to quality patient care in a supportive environment.

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