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Job description
Access Specialist | Patient Access RepresentativeJoin a compassionate healthcare team 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 FunctionsVerify 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 and other regulatory bodies.Participate in insurance and regulatory audits and data submissions.Ensure compliance with certification, Plan of Care, 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.Maintain accurate and timely documentation in accordance with agency policies.Foster effective communication and cooperation with physicians, staff, and clients to support reimbursement processes.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 SkillsProficient computer skills with advanced knowledge of medical record systems.Effective communication abilities.Intermediate proficiency in Microsoft Office.Strong keyboarding, filing, and data processing skills.Preferred Behavioral SkillsIntegrity: Demonstrates honesty and ethical behavior.Compassion: Shows empathy and excellent customer service.Accountability: Takes ownership and adapts to changing priorities.Respect: Collaborates well with diverse populations.Excellence: Communicates clearly and maintains high service standards.Education and ExperienceMinimum: High School Diploma.Preferred: Medical Terminology knowledge, medical office experience, and insurance authorization experience.Licenses and CertificationsRequired: Valid state driver's license and proof of auto liability insurance.Preferred: Associate's or Bachelor's Degree in Health Care or Business.This position offers competitive pay and a generous benefits package within a supportive healthcare environment serving the Midwest region.
Worksite address
abbyville, KS, 67510, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.