Access Coordinator

Essentia Health • Duluth, MN

12h • 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

Benefits

• medical, dental, vision, life, and disability insurance
• supplemental options
• 401(k) plan with employer contributions
• training, tuition reimbursement, and educational programs
• flexible scheduling
• generous time off
• wellness resources focused on your physical, mental, and emotional health

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: No Education Listed