Access Coordinator

Title: Access Coordinator

Location: Brainerd, MN

Work Type: Remote, Full Time

Job ID: R070798

Job Description:

Building Location:

St Josephs Medical Center

Department:

1007190 PRE-SERVICE AUTHORIZATION - EH SS

Job 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.

Gather necessary insurance information, use expertise to translate the information provided by the patient/guarantor into the computer system with the result of an accurate claim submission. May be responsible for some or all of the following: insurance verification, ICD 10 or HCPC code selection, prior authorization, pre-certification, medical necessity determination, referrals, workers compensation authorization, service estimates, patient communication when services are not covered, pre-service collections.

Key Responsibilities:
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

Education Qualifications:

Required Qualifications:

• 1 year of relatable healthcare experience

Preferred Qualifications:

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

Licensure/Certification Qualifications:

no

Weekends:

No

Holidays:

No

Call Obligation:

No

Union:

Compensation Range:

$17.45 - $26.18

Employee Benefits at Essentia Health: At Essentia Health, we’re committed to supporting your well-being, growth, and work-life balance. Our comprehensive benefits include medical, dental, vision, life, and disability insurance, along with supplemental options to fit your needs. We offer a 401(k) plan with employer contributions to help you plan for the future, and we invest in your professional development through training, tuition reimbursement, and educational programs. To help you thrive both at work and at home, we provide flexible scheduling, generous time off, and wellness resources focused on your physical, mental, and emotional health. Please note that benefit eligibility may vary.