Patient Access Specialist

• Review and validate insurance eligibility, prior authorization, and referrals for medications, procedures, and other services
• Collect documentation and communicate with third-party payers, healthcare professionals, and customers to prioritize requests
• Verify patient registration and benefit coverage, including deductibles and out-of-pocket expenses
• Research and verify covered benefits for ordered tests, procedures, and services
• Complete and confirm prior authorization for medical services, testing, procedures, surgery, DME, and medications
• Obtain diagnosis and CPT codes from medical charts or provider offices
• Contact third-party payers to determine the appropriate prior authorization process
• Work with provider offices to obtain and clarify documentation demonstrating medical necessity
• Guide provider offices on Advanced Beneficiary Notices or waivers when medical necessity criteria are not met
• Review professional services denials and work with clinics and third-party payers on appeals
• Ensure required referrals are in place and work on outgoing referrals for care outside Sanford Health
• Provide minimal telephone interaction with patients regarding provider referrals
• Notify insurance companies when patients check in for inpatient services and observation procedures
• Document work in the case management module and provide direction to utilization management, case management, and nursing
• Collaborate with case management, social work, utilization management, and other cross-functional teams
• Assist with data design and management, including preparing reports and presentations

Patient Access Specialist validating insurance and authorizations for Sanford Health’s rural care system

Patient Access Specialist validating insurance benefits, referrals, and prior authorizations for Sanford Health’s rural healthcare system. Coordinating documentation, payer communications, denials, and medical necessity reviews.

• Perform admitting duties for patients admitted for hospital services
• Assign accurate medical record numbers (MRNs)
• Complete medical necessity and compliance checks
• Provide patient instructions and collect insurance information
• Receive and process physician orders
• Use an overlay tool while providing customer service
• Operate the telephone switchboard for incoming, outgoing, and inter-office calls
• Meet assigned point-of-service goals
• Use quality auditing and reporting systems to ensure accounts are corrected
• Conduct account audits and provide statistical data to Patient Access leadership
• Pre-register patient accounts before visits, including inbound and outbound calls
• Obtain demographic, insurance, and other patient information, including financial liabilities
• Collect point-of-service collections and past-due balances, including payment-plan options
• Explain consent and patient education forms, obtain signatures, and document witnesses
• Review insurance eligibility responses and select applicable insurance plan codes
• Enter benefit data to support point-of-service collections and billing processes
• Screen Medicare medical necessity using ABN software and distribute ABNs as appropriate
• Distribute and document designated forms and pamphlets

Part-time onsite patient access specialist supporting hospital admissions for Ensemble’s healthcare revenue-cycle services

Patient Access Associate Specialist

Part-time onsite Patient Access Associate Specialist admitting hospital patients and managing registration, insurance verification, forms, and collections.
Supporting Ensemble’s technology-enabled healthcare revenue-cycle services.

• Perform admitting duties for all patients admitted for hospital services
• Assign accurate medical record numbers (MRNs)
• Complete medical necessity and compliance checks
• Provide patient instructions and collect insurance information
• Receive and process physician orders
• Use an overlay tool while providing customer service
• Operate the telephone switchboard and relay incoming, outgoing, and inter-office calls
• Meet assigned point-of-service goals
• Use quality auditing and reporting systems to correct accounts
• Conduct account audits and provide statistical data to Patient Access leadership
• Pre-register patient accounts before visits
• Make inbound and outbound calls to obtain demographic, insurance, and patient financial-liability information
• Collect point-of-service collections and past-due balances, including payment-plan options
• Explain consent forms, obtain signatures, and record witness names
• Explain and distribute patient education and required healthcare forms
• Review insurance eligibility responses and select applicable insurance plan codes
• Enter benefit data to support point-of-service collections and billing processes
• Screen Medicare medical necessity using ABN software and distribute ABNs when appropriate
• Distribute and document designated forms and pamphlets

Patient access specialist admitting patients onsite for Ensemble’s hospital revenue-cycle services

Patient access specialist admitting and preregistering hospital patients onsite. Supporting insurance verification, medical necessity screening, collections, and clean-claim billing for Ensemble’s healthcare revenue-cycle clients.

• Perform admitting duties for all patients admitted for hospital services
• Assign accurate medical record numbers (MRNs)
• Complete medical necessity and compliance checks
• Provide patient instructions and excellent customer service
• Collect insurance information and process physician orders
• Operate the telephone switchboard for incoming, outgoing, and inter-office calls
• Meet assigned point-of-service collection goals
• Use quality auditing and reporting systems to correct accounts
• Conduct account audits and provide statistical data to Patient Access leadership
• Pre-register patient accounts before visits through inbound and outbound calls
• Obtain demographic, insurance, and patient financial liability information
• Collect point-of-service payments and past-due balances, including payment plan options
• Explain and obtain signatures for consent and treatment forms
• Distribute patient education documents and designated forms
• Review insurance eligibility responses and enter benefit data to support collections and billing
• Screen Medicare medical necessity using ABN software and distribute ABNs when appropriate

Part-time Patient Access Specialist admitting patients for Ensemble’s hospital revenue-cycle services

Part-time Patient Access Specialist admitting hospital patients for Ensemble’s healthcare revenue-cycle management services. Handling registration, insurance verification, collections, and compliance documentation onsite in Big Stone Gap.

• Perform admitting and patient access duties for patients receiving services
• Assign accurate medical record numbers and complete medical necessity and compliance checks
• Provide patient instructions and collect insurance and demographic information
• Receive and process physician orders using an overlay tool
• Operate the telephone switchboard and relay calls
• Use quality auditing and reporting systems to correct accounts
• Develop training materials and programs for new hires
• Provide continuing education to associates across revenue cycle areas
• Develop staff schedules for the patient access department
• Provide on-call, after-hours support and cover unscheduled staffing needs
• Collect point-of-service payments, past-due balances, and offer payment plan options
• Conduct account audits and provide statistical data to Patient Access Leadership
• Explain consent, Medicare, observation, and other patient forms; obtain required signatures
• Review insurance eligibility, select plan codes, and enter benefit data to support collections and billing
• Pre-register patient accounts and make inbound and outbound calls to obtain patient information
• Screen Medicare medical necessity using ABN software and distribute and document required forms
• Provide compassionate customer service while meeting regulatory, policy, audit, and point-of-service goals

Senior Patient Access Specialist supporting hospital revenue cycle operations in Greenville

Senior Patient Access Specialist

Senior Patient Access Specialist supporting hospital revenue cycle operations for Ensemble Health Partners in Greenville. Handling admissions, insurance verification, patient forms, collections, audits, training, and scheduling.

• Coordinate complex duties supporting front-end revenue cycle and clinic functions for hospital and clinic operations
• Obtain, confirm, and enter demographic, financial, and clinical information for financial clearance of scheduled patient accounts
• Contact patients’ families or physicians’ offices to obtain missing insurance information
• Verify insurance eligibility and coverage benefits, and notify patients and referring physicians of failed eligibility
• Collaborate with scheduling departments to identify add-on patients
• Obtain authorizations, pre-certifications, and referrals
• Notify patients of liabilities before service and collect funds
• Maintain accurate records, files, and system documentation
• Serve as a lead resource for lower-level Patient Services staff
• Recommend approaches to enhance performance and productivity
• Respond to technical issues from patients, physicians, and employees via phone, email, web messages, and fax
• Build healthy relationships among staff, patients, and families while fostering compassion and caring
• Adhere to University and unit-level policies and procedures and safeguard University assets

Remote Patient Access Specialist coordinating insurance clearance for University of Miami Health System

Patient Access Specialist – Full Time

Remote Patient Access Specialist coordinating insurance verification, authorizations, and financial clearance for University of Miami Health System. Supporting patients, physicians, and clinic revenue-cycle operations.

• Responsible for performing admitting duties for all patients admitted for services at the hospital.
• Assigning accurate MRNs, completing medical necessity / compliance checks, providing proper patient instructions.
• Collecting insurance information, receiving, and processing physician orders.
• Utilizing an overlay tool while providing excellent customer service as measured by Press Ganey.
• Conducts audits of accounts and assures that all forms are completed accurate, timely to meet audit standards.

Entry level Patient Access Specialist at Ensemble providing admitting duties.

Entry level Patient Access Specialist at Ensemble providing admitting duties for patients in hospitals. Ensuring compliance, quality service, and effective admissions while monitoring patient information.

• Reviews and validates insurance eligibility, prior authorization and/or referral of medication, procedures, etc.
• Collects necessary documentation and communicates with third party payers, healthcare professionals and customers to prioritize requests.
• Verifies patient registration and confirms benefit coverage, including deductibles and out-of-pocket expenses; researches and verifies covered benefits for ordered tests, procedures, and other services.
• Responsible for assuring that prior authorization for medical services is completed and confirmed.
• Obtains diagnosis(es)/CPT code(s) from medical chart and/or provider office.
• Contacts third party payer to determine appropriate prior authorization process.
• Works closely with provider offices to obtain and clarify documentation to demonstrate medical necessity.
• Reviews professional services denials; works with clinics and third party payers on appeal process.

Patient Access Specialist validating insurance eligibility and prior authorizations for Sanford Health

Patient Access Specialist – Differential Waiver, Prior Authorization

Patient Access Specialist validating insurance eligibility and prior authorizations at Sanford Health. Responsible for ensuring proper documentation and communication with third-party payers and provider offices.

• Performing admitting duties for all patients admitted for services at the hospital
• Assigning accurate MRNs
• Completing medical necessity/compliance checks
• Collecting insurance information
• Pre-registering patient accounts prior to patient visits

Performing admitting duties for patients at Ensemble healthcare services

Responsible for admitting patients and processing medical information at Ensemble. Engaging in customer service and regulatory compliance to ensure smooth operations.

• Patient Access staff are responsible for assigning accurate MRNs
• Completing medical necessity / compliance checks
• Providing proper patient instructions
• Collecting insurance information
• Receiving and processing physician orders
• Conducting audits of accounts

Entry Level Patient Access Associate Specialist at Ensemble providing patient admitting duties

Entry Level Patient Access Associate Specialist at Ensemble providing admitting services at Mercy - Defiance Hospital. Responsible for patient admissions, insurance checks, and customer service.

• Greets patients and answers telephone calls
• Schedules appointment requests
• Indicates special needs (e.g. special accommodation, interpreter, etc.)
• Communicates insurance participation, financial responsibility, and time of service policy to patient population
• Obtain patients insurance and demographic information and ensure all obtained information is registered in EPIC
• Performs real-time insurance verification and interprets responses
• Collects pre-registration information to address outstanding Epic work queue accounts
• Performs outbound calls to perform Epic referral scheduling
• Contribute to the team by providing support and back-up coverage as needed and directed by Supervisor and/or Manager
• General faxing, filing, and mail sorting
• Performs other related duties as assigned

Patient Access Specialist I supporting ColumbiaDoctors' access center

Patient Access Specialist I

Patient Access Specialist I supporting ColumbiaDoctors' Call Center for patient scheduling and inquiries. Responsible for managing patient information, appointment scheduling, and assisting in a busy call center environment.

• Responsible for the financial counseling, collecting co-pays and deductibles and/or providing financial assistance education to patients and their families
• Responsible for stat registering, scheduling appointments, completion of registration by collecting and entering all pertinent financial and demographic information into the ADT system
• Verifying insurance benefit information, generation of the ABN, reviewing orders for compliancy, completion of MSP, obtaining financial and treatment consents, placing of ordered medical procedures, obtaining a pre-certification when applicable
• Demonstrate Customer Focus with Patience, Composure, and Compassion
• Deal with Ambiguity by effectively coping with change; possess strong Time Management skills, Interpersonal Savvy, while supporting Peer Relationships
• Demonstrates expert Functional/Technical skills while providing financial assessment and evaluation of each patient entering the hospital
• Comprehend the hospital’s financial policies, possess the ability to apply it to the patient, and secure payment for the patient’s hospital liability
• Maintain excellent customer service standards at all times in order to effectively communicate with physicians, physician offices, patients, and co-workers
• Efficiently perform all duties while ensuring patient confidentiality and privacy rights

Patient Access Specialist providing financial assistance and patient counseling remotely

Patient Access Specialist responsible for financial counseling and registration tasks. Providing assistance to patients while collaborating with healthcare professionals remotely.

• Responsible for performing admitting duties for all patients admitted for services at the hospital
• Assigning accurate MRNs and completing medical necessity / compliance checks
• Providing proper patient instructions and collecting insurance information
• Receiving and processing physician orders
• Conducting audits of accounts and assuring that all forms are completed accurately and timely
• Responsible for the pre-registration of patient accounts prior to patient visits
• Explaining general consent for treatment forms to the patient/guarantor/legal guardian

Patient Access Specialist performing admitting duties for hospital patients

Associate Specialist, Patient Access – Night Shift

Patient Access Specialist performing admitting duties for services at hospital. Collecting insurance information and ensuring effective patient admissions in Montclair, NJ.

• Performing admitting duties for all patients admitted for services at the hospital
• Assigning accurate MRNs and completing medical necessity / compliance checks
• Collecting insurance information and processing physician orders
• Conducting audits of accounts and assuring statistical data to Patient Access leadership
• Responsible for the pre-registration of patient accounts prior to patient visits
• Explaining general consent for treatment forms to the patient/guarantor/legal guardian

Patient Access Specialist performing admitting duties in a healthcare setting

Patient Access Specialist performing admitting duties for patients in a healthcare environment. Ensuring compliance with regulations and providing high-quality customer service at the hospital.

• Responsible for performing admitting duties for all patients admitted for services at the hospital.
• Assigning accurate MRNs, completing medical necessity / compliance checks, providing proper patient instructions, and collecting insurance information.
• Responsible for the utilization of quality auditing and reporting systems to ensure accounts are corrected.
• Responsible for the pre-registration of patient accounts prior to patient visits.
• Explains general consent for treatment forms to the patient/guarantor/legal guardian.
• Responsible for accurately screening of medical necessity using the Advanced Beneficiary Notice (ABN) software.

Patient Access Specialist performing admitting duties at HSHS - St. Joseph's Hospital.

Associate Specialist, Patient Access

Patient Access Specialist performing admitting duties for patients at HSHS - St. Joseph's Hospital in Breese, IL. Responsible for patient registration, insurance checks, and compliance requirements.

• Performing admitting duties for all patients admitted for services at the hospital.
• Assigning accurate MRNs, completing medical necessity / compliance checks.
• Providing proper patient instructions, collecting insurance information, receiving and processing physician orders.
• Conducting audits of accounts.
• Explaining general consent for treatment forms to the patient/guarantor/legal guardian.
• Reviewing eligibility responses in insurance verification system and entering benefit data into the system.

Patient Access Specialist managing admitting duties at HSHS - St. Clare Hospital

Associate Specialist, Patient Access – PRN

Patient Access Specialist handling admitting duties for patients at HSHS - St. Clare Hospital in Oconto Falls, WI. Responsible for compliance checks, insurance processing, and customer service.

• Deliver exceptional customer service to patients and internal customers
• Schedule and manage patient access to clinical services in the Connected Care Center
• Process incoming calls and handle various inquiries related to scheduling
• Verify and update patient demographics, including address, contact numbers, and primary care physician (PCP)
• Prepare for patient visits by reviewing established items and documenting their completion
• Collaborate with providers to maintain clinic templates in Epic
• Engage in relevant educational activities to enhance knowledge

Patient Access Resource Specialist providing customer service and scheduling support at OHSU

Temporary Patient Access Resource Specialist

Patient Access Resource Specialist providing scheduling support and patient care coordination at OHSU. Engaging in various administrative tasks efficiently while delivering high-quality customer service.

• Consistently practices Patients First philosophy and adheres to high standards of customer service.
• Responds to questions and concerns.
• Maintains patient confidentiality per HIPAA regulations.
• Provides exceptional customer service to patients.
• Correctly identifies and collects patient demographic information in accordance with organization standards.
• Reaches out to patients to schedule appointments.
• Completes other duties assigned by manager.
• Participates in Quality Assurance reviews to ensure integrity of patient data information.
• Uses effective service recovery skills to solve problems when they occur.

Patient Access Specialist managing patient interactions for Northwestern Medicine

Patient Access Specialist responsible for patient interactions at Northwestern Medicine. Ensuring high standards of customer service and collecting patient information accurately.

• Consistently practices Patients First philosophy and adheres to high standards of customer service
• Responds to questions and concerns
• Maintains patient confidentiality per HIPAA regulations
• Provides exceptional customer service to patients
• Correctly identifies and collects patient demographic information
• Interacts with various hospital departments and physicians offices
• Reaches out to patients to schedule an appointment
• Performs medical necessity checks as necessary
• Informs patients of any issues with securing financial account
• Completes out-of-pocket estimations as requested

Patient Access Specialist providing exceptional service at Northwestern Medicine

Patient Access Specialist providing exceptional service to patients at Northwestern Medicine. Handling inquiries, scheduling, and ensuring a positive patient experience in a healthcare setting.

• Compile, analyze and report on the performance of departmental operating units
• Analyze and provide feedback for department-specific reports
• Ensure accurate and compliant charge items
• Coordinate communication between insurance companies, governmental agencies, providers and support staff

Reimbursement Specialist for Oncology Patient Access at Duke Health

Reimbursement Specialist – Oncology Patient Access

Reimbursement Specialist responsible for performance analysis and reporting in Oncology Patient Access at Duke Health. Collaborating with departmental leaders to ensure accurate billing and compliance processes.

Patient Access Specialist jobs in United States

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Patient Access Specialist

Patient Access Associate Specialist

Patient Access Associate Specialist

Patient Access Specialist

Senior Patient Access Specialist

Patient Access Specialist – Full Time

Patient Access Specialist

Patient Access Specialist – Differential Waiver, Prior Authorization

Patient Access Associate Specialist

Patient Access Associate Specialist

Patient Access Specialist I

Patient Access Specialist

Associate Specialist, Patient Access – Night Shift

Patient Access Specialist

Associate Specialist, Patient Access

Associate Specialist, Patient Access – PRN

Temporary Patient Access Resource Specialist

Patient Access Specialist

Patient Access Specialist

Reimbursement Specialist – Oncology Patient Access