Access Coordinator - Remote

Job Description

The Access Coordinator gathers necessary insurance information and uses expertise to translate the information provided by the patient/guarantor into the computer system, resulting in accurate claim submissions.Gather necessary insurance information, use expertise to translate the information provided by the patient/guarantor into the computer system with the result of an accurate claim submission. May be responsible for some or all of the following: insurance verification, ICD 10 or HCPC code selection, prior authorization, pre-certification, medical necessity determination, referrals, workers compensation authorization, service estimates, patient communication when services are not covered, pre-service collections. Key Responsibilities:Prepares and submits payer-specific prior authorizations and referrals in alignment with relevant guidelines and medical policy criteriaAccurately identifies required insurance verification and medical documentation in accordance with payer policyCollaborates with clinicians and medical practitioners to obtain all necessary information for successful authorization approvalThoroughly documents all interactions and actions related to insurance processes within the electronic Medical Record (EMR) systemRegularly reviews and monitors assigned work queues, identifying, and focusing on accounts with the highest financial reimbursement riskAdapts to urgent clinical needs while maintaining high-quality work outputs within specified timelinesCommunicates with patients as needed to facilitate medical clearanceDevelops pre-service estimates and supports pre-service collectionsSupports the review of prior authorization requests that do not initially meet criteria and works collaboratively with relevant stakeholders to resolve issues or coordinate necessary clinician-to-health plan interventions

Education Qualifications

Required Qualifications:

• 1 year of relatable healthcare experience
  
  

Preferred Qualifications

• Healthcare experience within patient care, registration, scheduling, pre-certifications/prior authorizations, collections, and medical terminology
  
  

Licensure/Certification Qualifications

none

Employee Benefits at Essentia Health: At Essentia Health, we’re committed to supporting your well-being, growth, and work-life balance. Our comprehensive benefits include medical, dental, vision, life, and disability insurance, along with supplemental options to fit your needs. We offer a 401(k) plan with employer contributions to help you plan for the future, and we invest in your professional development through training, tuition reimbursement, and educational programs. To help you thrive both at work and at home, we provide flexible scheduling, generous time off, and wellness resources focused on your physical, mental, and emotional health. Please note that benefit eligibility may vary. For full details, refer to your benefit summary or contact our HR Service Center at (218) 576-0000.

Job Location: St Josephs Medical Center

Shift Rotation: Day Rotation (United States of America)

Shift Start/End: Days/Days

Hours Per Pay Period: 80

Compensation Range: $17.45 - $26.18 / hour

Union

FTE: 1

Weekends: No

Call Obligations

Sign On Bonus: