Access Associate | Patient Access Representative
MLee Healthcare Staffing and Recruiting, Inc, Abbyville, KS, United States
Access Associate | Patient Access Representative
Join a compassionate healthcare team as a Patient Access Representative, where your role is vital in ensuring smooth insurance verification and referral processing to support positive patient outcomes. You will be responsible for verifying insurance eligibility, obtaining pre-certifications, and assisting with referral intake to facilitate timely patient care.
Essential Functions
Verify insurance eligibility and benefits across various insurance providers.
Obtain pre-certifications and ongoing authorizations to support patient care continuity.
Assist with intake and referral processes, ensuring efficient staffing assignments to meet patient needs.
Maintain up-to-date knowledge of federal, state, and private reimbursement regulations, including CMS guidelines.
Participate in audits and data submissions required by insurance and regulatory bodies.
Ensure compliance with certification, PPOC, and Face to Face requirements.
Audit admissions and patient records for program-specific conditions and quality reporting.
Complete pre-billing and performance improvement chart audits as assigned.
Maintain accurate and timely documentation in accordance with agency policies.
Foster cooperative communication with physicians, staff, and clients to optimize reimbursement processes.
Support billing processes including generation and transmission of notices of election and admission.
Perform clerical duties such as managing phone calls and processing incoming faxes.
Adhere strictly to HIPAA regulations regarding Protected Health Information (PHI).
Education
Minimum: High School Diploma
Preferred: Associate's or Bachelor's Degree in Health Care or Business
Experience
Preferred experience includes medical terminology, medical office operations, and insurance authorization processes.
Requirements
Valid state driver's license and proof of auto liability insurance.
Advanced computer skills with proficiency in medical record systems and Microsoft Office.
Strong communication skills and ability to provide excellent customer service.
Integrity, compassion, accountability, respect, and a commitment to excellence in all interactions.
This position offers a competitive salary and benefits package within a supportive healthcare environment serving the Midwest region of the United States.
Join a compassionate healthcare team as a Patient Access Representative, where your role is vital in ensuring smooth insurance verification and referral processing to support positive patient outcomes. You will be responsible for verifying insurance eligibility, obtaining pre-certifications, and assisting with referral intake to facilitate timely patient care.
Essential Functions
Verify insurance eligibility and benefits across various insurance providers.
Obtain pre-certifications and ongoing authorizations to support patient care continuity.
Assist with intake and referral processes, ensuring efficient staffing assignments to meet patient needs.
Maintain up-to-date knowledge of federal, state, and private reimbursement regulations, including CMS guidelines.
Participate in audits and data submissions required by insurance and regulatory bodies.
Ensure compliance with certification, PPOC, and Face to Face requirements.
Audit admissions and patient records for program-specific conditions and quality reporting.
Complete pre-billing and performance improvement chart audits as assigned.
Maintain accurate and timely documentation in accordance with agency policies.
Foster cooperative communication with physicians, staff, and clients to optimize reimbursement processes.
Support billing processes including generation and transmission of notices of election and admission.
Perform clerical duties such as managing phone calls and processing incoming faxes.
Adhere strictly to HIPAA regulations regarding Protected Health Information (PHI).
Education
Minimum: High School Diploma
Preferred: Associate's or Bachelor's Degree in Health Care or Business
Experience
Preferred experience includes medical terminology, medical office operations, and insurance authorization processes.
Requirements
Valid state driver's license and proof of auto liability insurance.
Advanced computer skills with proficiency in medical record systems and Microsoft Office.
Strong communication skills and ability to provide excellent customer service.
Integrity, compassion, accountability, respect, and a commitment to excellence in all interactions.
This position offers a competitive salary and benefits package within a supportive healthcare environment serving the Midwest region of the United States.