Patient Access Specialist (PAS)

CND Life Sciences•Scottsdale, AZ

3d•Remote

About The Position

The Patient Access Specialist (PAS) completes core Patient Access functions from initial intake through completion of assigned patient accounts. Work includes fax triage, entering patient and insurance information, verifying eligibility and benefits, initiating and following up on prior authorizations, resolving missing information, and accurately documenting accounts. The PAS maintains ownership of assigned accounts and ensures required activities are completed accurately and within established turnaround times. The role collaborates with Patient Access, Revenue Cycle Management (RCM), Clinical Services, patients, referring offices, health plans, and other stakeholders. This is a remote position. Quarterly travel may be required for meetings at the Scottsdale, Arizona headquarters or Atlanta, Georgia regional office. The employee must work effectively remotely while maintaining confidentiality, productivity, and communication standards.

Requirements

At least 1 year of experience in healthcare patient access, benefit verification, prior authorization, or revenue cycle management.
Proficiency with Salesforce, Waystar, payer portals, and laboratory billing platforms.
Working knowledge of commercial and government insurance coverage.
Familiarity with medical insurance eligibility, benefits, prior authorization, and medical terminology.
Strong attention to detail, organization, time-management, problem-solving, and customer service skills.
Ability to manage multiple accounts and competing priorities in a fast-paced, remote, collaborative environment.
Professional verbal and written communication skills.
High school diploma or general education degree required.
Ability to work effectively in a remote environment while maintaining confidentiality, productivity, and communication standards.

Nice To Haves

Laboratory experience.
Related coursework or education, such as a billing certificate, associate’s degree, or bachelor’s degree focused on billing or a related field.

Responsibilities

Retrieve, review, and triage incoming faxes and other correspondence, identifying request type, urgency, required action, and missing information.
Enter and maintain patient demographics, insurance information, referring provider information, and other required data in Salesforce and designated systems.
Prioritize STAT, urgent, and time-sensitive requests, and own assigned accounts through completion.
Verify patient eligibility and insurance coverage using Waystar, payer portals, direct payer communication, and other authorized resources.
Complete benefit verifications within established turnaround times, including review of applicable commercial and government insurance benefits, secondary coverage, and coordination of benefits when applicable.
Determine whether prior authorization, referral, GAP exception, or other payer approval is required; initiate and submit requests with accurate supporting information.
Follow up on pending authorizations, respond to payer requests for additional information, and document authorization status, reference numbers, effective dates, payer communications, and determinations.
Escalate complex, delayed, or unresolved authorization or benefit matters according to established procedures.
Review accounts for missing documentation or information and proactively work toward resolution while maintaining accurate account statuses and notes.
Ensure completed accounts contain information necessary to support downstream Revenue Cycle processes.
Communicate professionally with patients, referring offices, health plans, Clinical Services, RCM, and other stakeholders; provide timely account updates and communicate barriers or delays.
Meet departmental expectations for accuracy, productivity, quality, and turnaround time; participate in quality reviews, coaching, training, and process improvement initiatives.
Maintain compliance with HIPAA, applicable regulations, payer requirements, and CND policies.
Perform other duties as assigned.