Position Summary: 

Assist in coordinating the pre-authorization and assistance programs. Provides timely communication to the providers and nursing staff and patients as it relates to insurance guidelines and pre-authorization process. Assists in assessment of patient financial needs. Provides information regarding available patient assistance programs. Assists in the claims denial process for insurance carriers and develops an appropriate appeals response as necessary.

Minimum Qualifications:

High School diplomaPreferred: 1 year in a hospital or outpatient  clinic settingPreferred: Previous ICD-10 and CPT codingPreferred: Previous experience in medical pre-authorization, case management and / or financial counseling

Essential Job Functions:

Verifies eligibility and benefit information with insurance companies and communicates with physicians and staff before services are scheduled. Collaborates with staff and referring clinics regarding pre-authorizations. Collaborates with staff regarding denials. Reviews patient assistant program guidelines for potential patient enrollment. Communicates and collaborates with Clinical Operations Manager.

Knowledge, Skills and Abilities

Demonstrates sound judgement, patience, and maintains a professional demeanor at all timesStrong interpersonal, verbal and written communication skillsCreativity, problem analysis and decision makingAbility to work varied shiftsExercises tact, discretion, sensitivity and maintains confidentialityComputer applications, MS Office, EMR, internet applications and standard office equipmentAbility to analyze, organize and prioritize work while meeting multiple deadlinesSelf-directed, completes assignments accurately, thoroughly and with minimal oversightStrong emotional intelligence, interpersonal and teamwork skills

The above statements are intended to describe the general nature and level of work being performed by people assigned to the job classification.  They are not to be construed as a contract of any type nor an exhaustive list of all job duties performed by individuals so classified.

77212050 Patient Access Management