Patient Access Specialist

Patient Access Specialist
Job Description
Patient Access Specialist serves as a critical virtual link between the Urgent Care Clinic front desk personnel (typically the Patient Service Representative) and Revenue Cycle Management (RCM) teams, ensuring seamless and accurate new and established patient registration, insurance verification and understanding, and supporting the PSR and patient with RCM billing and insurance claims processes. This role involves documenting and reporting trends and findings, correcting patient coverage or inaccuracy in registration, aid in time of service collection, and patient/guarantor contact information to optimize revenue cycle efficiency.
Patient Access Specialist

• Verify patient demographics, insurance coverage, and eligibility.
• Identify and resolve coverage discrepancies.
• Interpret insurance responses to determine accurate time of service collection.
• Document and report findings, including coverage issues and provide resolutions.
• Utilize EMR system to review and update patient information. Maintain accurate records of patient interactions.
• Identify and escalate complex accounts to supervisor/manager.
• Interfacing with clinic staff on patient billing and insurance questions or concerns.
• Meet or exceed productivity and quality standards and monthly KPIs.
• Support all other functions of the Revenue Cycle Team, as identified.
• Additional tasks required by leadership and/or company, as identified.

Minimum Qualifications

• 1+ years of experience in patient billing, outbound and inbound call and email communication, and collections.
• 1+ years of experience in understanding the policies of insurance companies and how they impact the patient.
• Motivated, dependable, and flexible with the ability to multi-task in a short amount of time.
• High School diploma or equivalent

Required Skills for Success

• Attention to detail, organized, critical thinking, and problem-solving skills
• Strong written and verbal communication
• Knowledge of company policies
• Time management and organizational skills
• Ability to maintain a consistent teamwork mentality
• Computer and MS Office Skills (Excel experience a must)
• Experience with electronic health records (EMRs) and patient engagement platforms
• Strong interpersonal skills
• Ability to motivate, support, and create a positive work environment

Recommended Skills for Success

• Knowledge of insurance payers, insurance verification, the AR/revenue billing lifecycle and appealing denied claims
• Energy, enthusiasm, and the ability to work under pressure in a high volume, fast paced, start-up environment
• Ability to work within a team environment and maintain a positive attitude
• Excellent documentation, verbal, and written communication skills as it relates to patient responsibility and collecting patient balances
• Ability to communicate directly with patient while handling conflict in a professional manner through using proper tone and technique with the patient