Customer Access and Reimbursement Specialist
About The Position
The Customer Access and Reimbursement Specialist helps ensure patients have seamless access to services and reimbursement. The role oversees patient financial assistance programs, verifies insurance benefits, manages prior authorizations, and addresses patient out-of-pocket balances. The specialist supports patients through reimbursement processes, communicates with healthcare providers and payers to obtain required approvals, and works with billing, clinical, and customer experience teams to resolve inquiries. The role also maintains accurate records, monitors relevant healthcare regulations and reimbursement policies, contributes to process improvement, and complies with privacy and other applicable regulations when handling patient and financial information.
Requirements
- Bachelor's degree in a related field.
- At least 2 years of experience in a healthcare setting; experience in revenue cycle operations or patient access is preferred.
- Proficiency in navigating and using healthcare billing systems.
- Strong understanding of insurance verification, prior authorization, and reimbursement processes.
- Excellent communication skills and ability to interact effectively with patients, payers, and internal stakeholders.
- Strong attention to detail, organization, and time management.
- Ability to work independently and collaboratively in a fast-paced environment.
Nice To Haves
- Experience in revenue cycle operations or patient access.
Responsibilities
- Coordinate timely patient access to services by verifying insurance coverage and benefits.
- Help patients navigate reimbursement, including explaining out-of-pocket costs and financial assistance programs.
- Manage prior authorization requirements by coordinating with healthcare providers, payers, and patients to obtain approvals.
- Review and reconcile patient balances and support accurate billing and collections processes.
- Provide patients with guidance on financial assistance programs and payment options.
- Collaborate with billing, clinical, and customer experience teams to resolve patient inquiries and concerns.
- Maintain accurate, current documentation of patient interactions and financial assistance applications.
- Stay informed about healthcare regulations and reimbursement policy changes that may affect patient access and reimbursement.
- Participate in process improvement initiatives to improve the efficiency and effectiveness of patient access and reimbursement processes.
- Follow applicable compliance and privacy regulations when handling patient information and financial data.
- Perform other job-related duties as assigned.
