Pre-Access Coordinator

This is a fully remote position, open to applicants in Arizona, +21 more states.

📋 Description

• Validate insurance eligibility, benefits, and network participation for physician practices, hospitals, and ambulatory surgery centers.

• Obtain authorizations and pre-certifications for scheduled procedures within specified timelines.

• Collaborate with clinical teams regarding unattainable authorizations and potential procedure delays.

• Reach out to payers and utilize electronic verification tools to authenticate coverage and benefit details.

• Confirm effective dates, copays, deductibles, coinsurance, out-of-pocket expenses, and group information.

• Input and update insurance data to facilitate billing, referrals, and account accuracy.

• Review coverage for same-day and future appointments while proactively addressing eligibility issues.

• Investigate and rectify insurance discrepancies, connecting patients and guarantors to the correct coverage.

• Communicate with provider offices to gather missing information and resolve verification issues.

• Prepare patient cost estimates and clarify financial responsibilities based on insurance benefits.

• Contact patients regarding coverage, estimated balances, and options for payment arrangements.

• Manage insurance verification, financial counseling, and patient account inquiries while adhering to productivity standards.

• Uphold HIPAA compliance.

• Contribute to process improvement initiatives and collaborate with team members and stakeholders.

⛳️ Requirements

• High school diploma or equivalent is required.

• A minimum of 1–2 years of experience in insurance verification, patient access, revenue cycle, medical billing, healthcare customer service, or a related field.

• Familiarity with EMR systems such as Meditech, Epic, Cerner, Allscripts, Nextgen, HST/Clarity, Waystar, or comparable platforms.

• Proficient in Microsoft Office Suite (Word, Excel, Outlook, PowerPoint, Teams) and other business applications.

• Skilled in electronic insurance verification tools and online resources.

• Knowledgeable about commercial and government insurance plans, including HMO, PPO, POS, and Open Access plans.

• Strong attention to detail while reviewing, maintaining, and updating insurance and account information.

• Excellent verbal and written communication abilities.

• Strong organizational, time management, and multitasking capabilities.

• Ability to conduct sensitive financial discussions professionally and discreetly.

• Capable of working both independently and collaboratively within a team setting.

• Demonstrates reliability, punctuality, and excellent attendance.

• Candidates will undergo criminal background checks, employment verification, and government exclusion checks as a condition of employment.

🏝️ Benefits

• Criminal background check, employment verification check, and government exclusion check as part of the hiring process.