Patient Access Specialist

1-3 Years

Posted 4 hours ago
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Job Description

The Patient Access Specialist is responsible for managing the accurate and timely registration of new and returning patients by validating demographics, insurance information, and coordination of benefits (COB). The role supports healthcare revenue cycle operations by verifying payer eligibility, identifying authorization requirements, resolving insurance discrepancies, and ensuring complete documentation within EMR and practice management systems to support accurate billing and clean claim submission.

Tasks and Responsibilities:

Review and audit patient intake packets to identify new versus readmitted patients.
Create and maintain accurate patient profiles by validating demographic and registration information.
Determine and document appropriate insurance payer sequencing, including primary, secondary, and tertiary coverage when applicable.
Perform insurance eligibility verification across commercial insurance, Medicare, Medicaid, and other third-party payers.
Navigate multiple payer portals and systems to validate coverage details and resolve insurance discrepancies.
Conduct outbound calls to insurance companies and eligibility departments as needed.
Collaborate with facility business offices, providers, payers, and internal teams to resolve missing or conflicting insurance information.
Identify payer authorization requirements and submit prior authorization requests when necessary.
Maintain detailed documentation of all insurance verification and registration activities performed on patient accounts.
Prioritize registration tasks based on patient urgency, wound-round schedules, and operational deadlines.
Respond to intake inquiries through email and phone communication.
Handle incoming business office calls and provide appropriate support.
Maintain compliance with HIPAA privacy and security requirements when handling confidential patient information.
Perform other related duties as assigned.

Qualifications:

Minimum of one (1) year experience in U.S. healthcare, medical billing, revenue cycle operations, prior authorization, patient access, or a related healthcare administrative role.
Experience handling commercial insurance, Medicare, Medicaid, and other third-party payer processes.
Experience with insurance verification, eligibility checks, coordination of benefits (COB), or patient registration.
Experience in Microsoft Office applications, including Teams, Outlook, Excel, and Word.
Has knowledge in HIPAA privacy and security requirements.
Experience navigating multiple healthcare systems, payer portals, and applications simultaneously.
Demonstrates strong knowledge of healthcare administrative processes and patient information management.
Demonstrates strong attention to detail with the ability to maintain accuracy in a high-volume environment.
Demonstrates strong organizational and time management skills with the ability to prioritize competing deadlines.
Proven ability to work independently while maintaining productivity, accountability, and quality standards.
Proven ability to collaborate effectively with internal teams, facilities, providers, and external stakeholders.
Clear and coherent both written and verbal communication skills in English.

Work Location: Work from home

Work Schedule: 12:00 AM - 9:00AM (Tuesday to Saturday, Philippine Time)

What awaits you