Patient Access Specialist Job at Coastal Horizons Center
GENERAL STATEMENT OF DUTIES:
The Patient Access Specialist is responsible for reviewing and verifying client demographic and financial information prior to intake. Responsible for preparing financial agreement, based on information obtained from private insurer, and obtaining client signature. Responsible for coordinating client with appropriate clinician based on client’s funding and clinician availability. Responsible for tracking and submitting authorizations accurately and efficiently to ensure all rendered services are authorized within contractual guidelines and billable.
ESSENTIAL DUTIES AND TASKS:
- Review client intake paperwork including insurance information to determine mental health benefits; if client is uninsured, determine eligibility for state funding.
- Prepare financial agreements and obtain client signatures.
- Schedule intake appointments with the appropriate clinician.
- Submit enrollments and updates to MCOs.
- Monitor client’s utilization of unmanaged units and notify clinicians when authorization for continued services is needed.
- Review clinical documentation for completeness and submit to MCO for authorization requests.
- Follow up with MCO to determine approval or denial of authorization requests in a timely manner and effectively communicate with clinician.
REQUIRED EDUCATIONAL/EXPERIENTIAL QUALIFICATIONS
- High school diploma or GED with 2-3 years experience related to responsibilities specified.
- Knowledge of electronic health care systems, clinical documentation, and standards.
- Familiar with DSM and ICD-10 codes
- Previous experience with identifying insurance benefits and collecting payments
- Knowledge of state funded terminology
- Basic computer skills including Excel
SALARY: Commensurate with education and experience. Benefits available include health/medical, dental, life insurance, paid time off programs, 401 K retirement savings plan. For more information, please visit our website at www.coastalhorizons.org.
NOTICE: All employees hired after September, 20, 2021, must either provide proof of a COVID vaccination prior to hire or become fully vaccinated before their first date of employment. Prospective employees who want to be considered for a medical or religious exemption shall provide documentation for this request.
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