Patient Access Specialist (FT, Days)

About the role

The Patient Access Specialist plays a crucial role in facilitating timely access to care by verifying patient eligibility and benefits, coordinating Medicaid applications, and resolving registration and enrollment issues.

Responsibilities

• Ensures patient eligibility and benefits are verified prior to service and updates the information in the Electronic Health Record (EHR) accordingly.
• Affords assistance in determining if a patient qualifies for Medicaid or the Federal Marketplace insurance coverage and assists in the application process.
• Works with health plans to obtain coverage for uninsured patients seeking services within Connections Health Solutions (CHS).
• Reconciles daily visits with requested and confirmed applications.
• Responsible for correcting any claims denied or rejected for eligibility or benefits as it relates to the appropriate payer associated with the individual’s account.
• Researches and resolves registration and enrollment issues during an individual's stay.
• Ensures the accuracy of patient demographic information, updating as necessary.
• Verifies eligibility and benefits for daily visits in accordance with CHS procedures.
• Affords assistance in obtaining missing data to support eligibility determinations.
• Communicates necessary information regarding individual’s insurance carrier.
• Tracks Medicaid applications, ensuring completeness and acceptance.
• Updates Electronic Health Record (EHR) with pertinent information required for timely and accurate billing.
• Resolves registration and authorization issues during the individual in crisis visit.
• Reviews eligibility software daily to correct errors identified during the individual's visit.
• Affords assistance in identifying the appropriate Financial Assistance Program that meets the individual's needs.
• Collaborates with clinical operations and RCM teams to coordinate additional information.
• Performs checkout review to ensure that no additional information is needed before claim submission.
• Performs all other duties as assigned.

Requirements

• High School diploma or equivalent.
• 2 years of medical billing (eligibility) experience.
• Working knowledge of Medicaid, Medicare, and Commercial products.

Qualifications

• Bachelor’s degree in Health care or related field preferred.
• 5 years physician, hospital, and/or facility billing within a multi-specialty environment.

Skills

• Bilingual in Spanish.
• Certified Training (CPR, First Aid, etc.).

Benefits

• Comprehensive health insurance, including Medical, Dental, Vision, Accident, Critical Illness, and Hospital Indemnity.
• Short and Long-Term Disability.
• Flexible Spending Accounts (health care and dependent care).
• 401k company match after 6 months (50% of deferrals up to 6% of compensation).
• Generous PTO starting at 160 hours accrued annually and 12 recognized company holidays.
• Company-paid parental leave available to eligible employees.

Pay

Full-time only: Employees (and their families) are offered comprehensive health insurance, including Medical, Dental, Vision, Accident, Critical Illness, and Hospital Indemnity.

Schedule

Full-time only.