Patient Access Specialist

Coastal Horizons Center•Wilmington, NC

19h•Onsite

About The Position

The Patient Access Specialist is responsible for reviewing and verifying client demographic and financial information prior to intake. Responsible for preparing financial agreement, based on information obtained from private insurer, and obtaining client signature. Responsible for coordinating client with appropriate clinician based on client’s funding and clinician availability. Responsible for tracking and submitting authorizations accurately and efficiently to ensure all rendered services are authorized within contractual guidelines and billable.

Requirements

High school diploma or GED with 2-3 years experience related to responsibilities specified.
Knowledge of electronic health care systems, clinical documentation, and standards.
Familiar with DSM and ICD-10 codes
Previous experience with identifying insurance benefits and collecting payments
Knowledge of state funded terminology
Basic computer skills including Excel
Strong organizational, problem solving and analytical skills.
Working knowledge of cash management principles and/or procedures.
Proficient with MS Office.

Responsibilities

Review client intake paperwork including insurance information to determine mental health benefits; if client is uninsured, determine eligibility for state funding.
Prepare financial agreements and obtain client signatures.
Schedule intake appointments with the appropriate clinician.
Submit enrollments and updates to MCOs.
Monitor client’s utilization of unmanaged units and notify clinicians when authorization for continued services is needed.
Review clinical documentation for completeness and submit to MCO for authorization requests.
Follow up with MCO to determine approval or denial of authorization requests in a timely manner and effectively communicate with clinician.
Work directly with MCO and private insurances.
Excellent interpersonal and communication skills, possesses experience and competency in customer relation skills.
Ability to organize and prioritize work in a stressful environment.
Encourages teamwork; energetic, and motivates team and individuals.
Maintains a cooperative work environment to foster Coastal Horizons Center’s missions and values to meet goals.
Performs miscellaneous job-related duties as assigned.