Access Coordinator, Patient Access, Full Time, First Shift

UC Health • Cincinnati, OH

3d

About The Position

The Access Coordinator verifies insurance coverage for clinic patients receiving diagnostic testing, such as CT and MRI, chemotherapy, radiation therapy, and surgical procedures. The associate obtains prior authorizations and/or predeterminations for these services to help ensure maximum reimbursement to the organization.

The role verifies patient benefits and precertifies outpatient services, documents eligibility, benefits, and precertification details in Epic, organizes daily worklist tasks, and secures applicable accounts within established timelines and department productivity and quality standards. The coordinator follows up on missing information or problem accounts and communicates trends, registration issues, improvements, problems, and changes to department management. Other duties may be assigned.

Requirements

• High school diploma or GED.
• 1–2 years of equivalent experience completing precertifications or prior authorizations in a hospital setting, medical office setting, Patient Access, or similar environment.

Nice To Haves

• 3–5 years of equivalent experience completing precertifications or prior authorizations in a hospital setting, medical office setting, Patient Access, or similar environment.

Responsibilities

• Initiate online verification and/or contact insurance carriers and plan administrators by phone to verify patient benefits and precertify outpatient services.
• Ensure authorization is obtained for scheduled and non-scheduled high-dollar outpatient procedures.
• Follow up on missing data or problem accounts.
• Document complete and accurate eligibility, benefits, and precertification information in appropriate Epic database fields.
• Inform management of trends in incomplete data, registration issues, and related matters.
• Organize and prioritize daily worklist tasks effectively.
• Secure applicable accounts within the timeframes defined by the Due Diligence Standard while meeting department productivity and quality standards.
• Report improvements, problems, and changes related to insurance verification to department management.
• Perform other duties as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED