Access Coordinator

Essentia Health•Duluth, MN

2d•$20 - $30•Remote

About The Position

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. 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.

Requirements

1 year of relatable healthcare experience

Nice To Haves

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

Responsibilities

Prepares and submits payer-specific prior authorizations and referrals in alignment with relevant guidelines and medical policy criteria
Accurately identifies required insurance verification and medical documentation in accordance with payer policy
Collaborates with clinicians and medical practitioners to obtain all necessary information for successful authorization approval
Thoroughly documents all interactions and actions related to insurance processes within the electronic Medical Record (EMR) system
Regularly reviews and monitors assigned work queues, identifying, and focusing on accounts with the highest financial reimbursement risk
Adapts to urgent clinical needs while maintaining high-quality work outputs within specified timelines
Communicates with patients as needed to facilitate medical clearance
Develops pre-service estimates and supports pre-service collections
Supports 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