Access Coordinator - Remote

Building Location:Fargo Distribution Serv Center

Department:47190 Pre-Service Authorization

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:

none

FTE:1

Possible Remote/Hybrid Option:

Remote

Shift Rotation:Day Rotation (United States of America)

Shift Start Time:Days

Shift End Time:Days

Weekends:No

Holidays:No

Call Obligation:No

Union:

Union Posting Deadline:

Compensation Range:

$17.27 - $25.91

Employee Benefits at Essentia Health*:

• Health Coverage: Medical, dental, vision, life and disability insurance, plus supplemental health benefit options to ensure employees' well-being.

• Retirement Savings Plans: 401(k) with employer contributions to support long-term financial security.

• Professional Development: Opportunities for career growth through training, tuition reimbursement, and educational programs.

• Work-Life Balance: Flexible scheduling, time off, holidays, and personal leave to help employees manage their professional and personal lives.

• Employee Wellness Programs: Initiatives focused on physical, mental, and emotional health, including fitness memberships, counseling services, and wellness activities.

*Eligibility for Essentia Health’s benefit programs vary. Please refer to the benefit summary provided to you, or contact our HR Service Center at (218) 576-0000 for more information.