Job Description
The Patient Access Specialist I (PASI) will be responsible for performing all the functions needed to complete benefit verifications (BVs) from start to finish.; as well as be responsible for initiating prior authorizations (PAs). The PASI will work closely with members of the Patient Access, Revenue Cycle Management, and Clinical Services Departments daily.
Job Responsibilities:
- Collect and enter all patient and insurance information relevant to completing BVs, PAs, and other pre-authorizations into CND's customer relationship management platform (Salesforce) in a highly accurate and timely manner.
- Pull faxes and triage correspondence received in the department.
- Complete BVs, PAs, and other pre-authorizations in a highly accurate and timely manner (in accordance with their priority level) to fully meet the business needs of CND.
- Check the department email for requests and resolutions.
- Fully utilize Waystar along with other previously authorized online portals to process BVs, PAs, GAPs and/or Referrals to meet turnaround time expectation, increase accuracy and drive efficiency.
- Ensure patient charts are updated and BV & PA statuses are accurately assigned/identified.
- Regularly liaise with Clinical Services, RCM, and other members of the Patient Access team to support their functions related to BVs, PAs, and other pre-authorizations.
- Always comply with HIPPA and all other applicable regulations as well as CND's policies.
- Other duties as assigned.
Knowledge, Skills & Experience:
- Previous experience completing BVS, PAs and other pre-authorizations as well as medical billing
- Always act in a highly compliant and professional manner.
- Understand and apply knowledge of the U.S. healthcare system as well as government and commercial U.S. health insurance and coverage.
- Understand and apply knowledge of medical front office processes and terminology.
- High attention to detail and highly accurate documentation of information.
- Strong customer service skills to be used in internal communications with the RCM and Clinical Services teams.
- Strong analytical skills to organize data, interpret data and to enable problem solving.
- Excellent poise and professionalism in verbal and written communication.
- Strong ability to work effectively in fast-paced, dynamic team environments.
- Excellent time management.
- Strong ability to multitask.
Education, Certifications & Licensures:
- High school diploma or GED certificate required.
- Associate degree preferred.
Other:
- Ability to use computers, software, and related platforms.
- Must possess the ability to sit or stand for long periods
- This position is fully remote with the possibility of travel between CND's Scottsdale, AZ or Atlanta, GA offices a couple times per year.