[Hiring] Pre-Services Access Coordinator @Essentia Health

Role Description

The Access Coordinator gathers necessary insurance information and uses expertise to translate the information provided by the patient/guarantor into the computer system, resulting in accurate claim submissions.

• Prepares and submits payer-specific prior authorizations and referrals in alignment with relevant guidelines and medical policy criteria.
• Accurately identifies required insurance verification and medical documentation in accordance with payer policy.
• Collaborates with clinicians and medical practitioners to obtain all necessary information for successful authorization approval.
• Thoroughly documents all interactions and actions related to insurance processes within the electronic Medical Record (EMR) system.
• Regularly reviews and monitors assigned work queues, identifying and focusing on accounts with the highest financial reimbursement risk.
• Adapts to urgent clinical needs while maintaining high-quality work outputs within specified timelines.
• Communicates with patients as needed to facilitate medical clearance.
• Develops pre-service estimates and supports pre-service collections.
• Supports the review of prior authorization requests that do not initially meet criteria and works collaboratively with relevant stakeholders to resolve issues or coordinate necessary clinician-to-health plan interventions.

Qualifications

• 1 year of relatable healthcare experience.

Requirements

• Healthcare experience within patient care, registration, scheduling, pre-certifications/prior authorizations, collections, and medical terminology.

Benefits

• Comprehensive medical, dental, vision, life, and disability insurance.
• Supplemental options to fit your needs.
• 401(k) plan with employer contributions.
• Professional development through training, tuition reimbursement, and educational programs.
• Flexible scheduling and generous time off.
• Wellness resources focused on physical, mental, and emotional health.