Patient Access Specialist - 100% Remote in PST, MST or CST Time Zones

About the role

The Patient Access Specialist provides advanced support across the client journey by independently resolving moderately complex insurance, authorization, billing, and care-readiness issues. This role serves as a knowledgeable resource for escalations, ensures accuracy across workflows that impact client outcomes, and partners closely with internal teams to prevent delays in care.

Responsibilities

• Deliver an outstanding, responsive customer experience by supporting patient, family, referral source, and insurance inquiries across phone, email, text, and chat.
• Manage high-complexity insurance workflows, including secondary coverage, nuanced benefit structures, and multi-step authorization requirements.
• Manage inbound support requests and conduct proactive outreach to collect required documentation, close gaps in care, resolve concerns, schedule client appointments and improve overall client outcomes.
• Verify insurance benefits with accuracy, determine coverage/benefit limits, and ensure timely financial clearance prior to services.
• Prepare, submit, and track prior authorizations using appropriate systems; communicate authorization status, issues, and requirements to clinicians, clients, and internal teams.
• Support billing and financial inquiries by explaining charges, EOBs, deductibles, copays, payment plans, and financial policies; collect and process payments securely.
• Partner closely with clinical, scheduling, and operations teams to ensure accurate treatment plan alignment, session readiness, and continuity of care.
• Respond to internal inquiries about the status of in-process cases in a timely manner.
• Partner with the Revenue Integrity and Payer Compliance teams to resolve front-end rejections and registration related denials which includes collecting and updating patient billing information to ensure accurate submission/resubmission of claims.
• Maintain exemplary documentation quality in CRM/EHR systems, ensuring compliance with HIPAA, PCI, payer rules, and internal policies.
• Identify recurring issues or inefficiencies and recommend updates to workflows, job aids, or scripts; support pilots and process-improvement initiatives.
• Aid in onboarding and training of new team members by modeling strong communication, documentation, and case management practices.
• Manage an independent caseload, consistently meeting SLAs, quality standards, and follow-through expectations across all assigned work.

Requirements

• High school diploma or GED required.
• Associate’s degree or coursework in healthcare administration, business, or a related field preferred.
• 2–3+ years of experience in healthcare operations, patient access, insurance verification, prior authorization, medical billing, or revenue cycle support.
• Demonstrated success meeting SLAs and quality metrics in a high-volume environment.
• Prior experience in telehealth or multi-state healthcare environments preferred.
• Prior experience working in a fast-paced environment with measurable performance metrics (e.g., SLAs, quality standards).

Qualifications

• Proficiency with EHR/CRM systems and payer portals; ability to navigate multiple systems simultaneously.
• Strong data-entry accuracy and documentation discipline.
• Working knowledge of insurance terminology (EOBs, COB, medical necessity, visit limits, tiered benefits, etc.).
• Ability to recognize workflow issues and recommend improvements.
• Strong written and verbal communication skills for both client-facing and internal collaboration.

Skills

• Advanced problem-solving & case resolution.
• Workflow ownership & accountability.
• Cross-functional collaboration.
• Client experience leadership.
• Compliance & accuracy mastery.

Benefits

• Exceptional paid time off policies that encourage and support life balance, including a winter break.
• 401k matching to ensure our staff have what they need to enjoy their retirement.
• Health insurance options that ensure well being for the whole person and their family.
• Company paid life, short-term disability, and long-term disability coverage.
• Remote work environment that strives for connectivity through professional collaboration and personal connections.

Pay

$23.00-$26.00 per hour

Schedule

100% Remote