Patient Access Lead

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

📋 Description

• Assist the Patient Services department in facilitating the infusion admission process.

• Manage referrals and updated orders, which includes verifying insurance eligibility and benefits, obtaining prior approvals, and performing data entry.

• Ensure continuity of care by reviewing and maintaining eligibility, financial documents, and renewing prior approvals before patient appointments.

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

• Conduct audits, reviews, quality assurance assessments, and generate routine reports.

• Train both new and existing staff, which includes onboarding and refresher training sessions.

• Address escalated needs, calls, concerns, and performance issues within the team.

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

• Keep updated on insurance contracts, exclusions, CPT, HCPCS, ICD-10 codes, and drug copay assistance requirements.

• Adhere to HIPAA regulations and maintain patient confidentiality at all times.

• Create, manipulate, maintain, and review Excel spreadsheets and data reports.

• Communicate effectively with insurers, referring offices, patients, internal and clinical staff, as well as Patient Services teams.

• Monitor team workload and productivity while coordinating coverage assistance as needed.

• Support Patient Access Managers in achieving team goals, guidelines, expectations, process modifications, and coverage matters.

• Suggest enhancements to processes and procedures for improved efficiency.

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

• Participate in and co-present during weekly calls.

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

• Maintain patient records in the electronic Medical Record System.

• Attend departmental meetings and foster a positive image for the Home Office.

⛳️ Requirements

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

• At least 2 years of experience in medical billing and authorizations or managing physician referrals.

• A minimum of 1 year in a customer service or patient-facing position.

• At least 3 years of relevant prior work experience, ideally in admission, scheduling, and medical insurance within the healthcare sector.

• Proven competencies may be considered in lieu of prior work experience.

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

• Proficient at an intermediate level in all Microsoft Office applications.

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

• Exceptional communication and interpersonal skills.

• Fluent in both written and spoken English.

• Experience supporting multiple managers or supervisors.

• Prior experience handling sensitive information while maintaining confidentiality.

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

• Willingness to travel up to 10%.

• Capability to perform each essential duty satisfactorily.

• Ability to utilize required safety equipment/PPE when necessary.

🏝️ Benefits

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

• Private Equity for the Greater Good - 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%.

• Paid Time Off (PTO): Accrual of over 3 weeks.

• PTO Rollover and PTO Donation Program.

• Wellness Reimbursement Program - $360 Annually.

• Employee Referral Bonus - Unlimited Bonus Potential.

• Tuition Assistance Program & Professional Association Reimbursement.

• Employee Assistance Program (Provided by Employer).

• Short & long-term disability coverage (Provided by Employer).

• Life Insurance (Provided by Employer).

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

• Remote work from a secure home office.

• Opportunities for professional growth and advancement.