Patient Access Lead

This is a fully remote position, open to applicants in Arizona, +26 more states.

📋 Description

• Assist the Patient Services department and streamline the infusion admission process.

• Ensure accurate and comprehensive processing of referrals and updated orders, which includes verifying insurance eligibility and benefits, obtaining prior approvals, and data entry.

• Review and manage patient eligibility, current financial documents, and renewals for prior approvals ahead of appointments.

• Prioritize, organize, and delegate responsibilities to Patient Access Specialists.

• Conduct quality assurance audits and reviews.

• Provide training for new and existing employees, which includes onboarding and refresher courses.

• Address escalations, concerns, and phone inquiries.

• Act as a subject matter expert on Patient Access functions, systems, resources, tools, and procedures.

• Support Patient Access functions and Patient Services workload as business needs arise.

• Maintain updated knowledge of insurance contracts, exclusions, CPT, HCPCS, ICD-10 codes, and drug copay assistance requirements.

• Adhere to HIPAA regulations.

• Create, manipulate, and manage Excel spreadsheets and data-management reports.

• Communicate effectively with insurers, referring offices, patients, internal staff, and clinical personnel.

• Collaborate with Patient Navigator, Medical Records Review, and Patient Resources teams concerning patient accounts, referrals, documentation, insurance, financial documents, and prior approvals.

• Monitor team workload and productivity.

• Generate daily, weekly, monthly, and ad hoc reports, including schedule reviews and authorization tracking reports.

• Assist leadership with process modifications, coverage, and guideline updates.

• Ensure timely handling of referrals and orders through coordinated workload coverage.

• Identify and escalate team performance issues, providing peer feedback as needed.

• Participate in and co-present during weekly calls.

• Assist with claims projects, patient data audits, acquisition support, month-end activities, and various other projects.

• Maintain patient records and confidentiality within the electronic Medical Record System.

• Attend essential department meetings and perform additional duties as assigned.

⛳️ Requirements

• A minimum of 3 years of relevant prior work experience is required, ideally in admissions, scheduling, and medical insurance within the healthcare sector.

• At least 3 years of experience in high-volume insurance verification, benefits, eligibility, and authorizations.

• A minimum of 2 years in medical billing and authorizations or managing physician referrals.

• At least 1 year of experience in a customer service or patient-facing role.

• High school diploma or equivalent is required; an associate or bachelor’s degree is preferred.

• Proven competencies may take precedence over previous work experience.

• Intermediate proficiency in all Microsoft Office applications.

• Advanced knowledge of insurance, accounting, medical billing, HIPAA, Medicare/Medicaid, medical abbreviations, and terminology.

• Excellent communication and interpersonal skills.

• Fluency in both written and spoken English.

• Experience supporting multiple managers or supervisors.

• Previous experience handling sensitive information and maintaining confidentiality.

• Ability to satisfactorily perform each essential duty.

• Must reside in one of the specified states at the time of employment.

• Proof of eligibility to work in the US is required.

• Minimal travel may be required, up to 10%.

🏝️ Benefits

• Target Bonus Plan: 5% Annually (Based on performance).

• Company-wide Employee Ownership Program.

• Medical, Dental, and Vision coverage.

• HSA with Employer Contribution.

• Touchcare - Insurance Concierge Service.

• 401K with a Match up to 4%.

• PTO: Accrual of 3+ weeks PTO.

• PTO Buy-back, PTO Rollover, and PTO Donation Program.

• Wellness Reimbursement Program - $360 Annually.

• Employee Referral Bonus - Uncapped Bonus Potential.

• Tuition Assistance Program & Professional Association Reimbursement.

• Employee Assistance Program (Employer-provided).

• Short & long-term disability (Employer-provided).

• Life Insurance (Employer-provided).

• Flexible hours from 7:00 am to 7:00 pm EST.

• Opportunities for growth and advancement.

• Competitive benefits that support what matters most to you.