Patient Access Procedure Coordinator (M-F)

Cleveland Area Hospital•Cleveland, OK

just now•Onsite

About The Position

The Patient Access Procedure Coordinator plays a critical role in the operational success of Cleveland Area Hospital by ensuring that all services provided to patients are authorized by their insurance carriers. This position is responsible for verifying insurance coverage, assessing the medical necessity of services, and facilitating the authorization process to optimize reimbursement and reduce claim denials. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential function.

Requirements

High School diploma or equivalent.
Must possess excellent communication and organizational skills.
Working knowledge of computer-based applications and strong PC/keyboard skills are a must.
Strong knowledge of insurance policies, medical necessity criteria, and healthcare regulations.
Excellent communication and interpersonal skills, with the ability to interact effectively with patients and insurance representatives.
Proficient in using medical billing software and electronic health record (EHR) systems.
Exceptional organizational skills and attention to detail, with the ability to manage multiple tasks and meet deadlines.
1-2 years of experience in the medical field, hospital, or physician office.
Insurance verification, or authorization role preferred.
This position could have access to patient confidential records and must comply with HIPAA regulations as well as Compliance Policies.

Responsibilities

Adhere to all policies of the organization.
Conduct thorough verification of patients' insurance coverage prior to scheduled services.
Confirm eligibility and benefits with insurance providers to ensure services are covered under the patient’s plan.
Verify orders from referring providers are complete and information is accurate.
Review diagnosis codes to determine the medical necessity of requested services.
Collaborate with healthcare providers to obtain additional clinical information as needed to support authorization requests.
Obtain and/or confirm authorizations for services from insurance companies.
Monitor the status of authorization requests and follow up with insurers to expedite processing.
Maintain accurate records of authorization requests, approvals, and denials.
Communicate effectively with the billing and coding departments to resolve any discrepancies related to authorizations.
Inform patients of their insurance benefits and any necessary out-of-pocket costs related to their services.
Address patient inquiries regarding authorization status and insurance coverage in a professional and empathetic manner.
Stay updated on insurance policies, regulations, and changes that may affect authorization processes.
Other duties as assigned.

Benefits

Competitive pay
Comprehensive benefits package including medical, dental, vision, FSA, and Life/AD&D
401k with up to 4% matching after first year
Excellent PTO accrual from the date of hire
Generous Tuition Reimbursement Program
Employee Appreciation and Engagement
Birthday, Anniversary and New Hire Gifts
Uniform Vouchers (annually and upon hire)
Employee Engagement events
Employee Referral incentives