Patient Access Specialist

Essential Responsibilities:

• Manage a high volume of inbound and outbound calls with professionalism and courtesy.
• Verify patient eligibility and insurance benefits using online tools or by contacting insurers directly.
• Educate patients about their insurance coverage, out-of-pocket costs, and available options for financial assistance.
• Administer financial assistance programs.
• Submit and manage prior authorization cases, ensuring timely follow-up and resolution.
• Accurately document all interactions and follow-up activities in the billing system.
• Obtain and manage all necessary documentation, collaborating with internal revenue cycle and customer success teams.
• Build positive relationships with patients and stakeholders to resolve issues effectively.
• Support additional duties, special projects, or process improvement initiatives as needed.

Education and Experience Requirements:

• Associates degree required.
• 1-3 years experience relevant healthcare experience.
• Strong knowledge of medical benefits, insurance policies, coordination of benefits (COB), prior authorization workflows, and payer requirements for reimbursement from Medicare, Medicaid, and commercial insurances.
• Customer-focused approach with the ability to handle high-pressure situations.
• Exceptional organizational, problem-solving, and communication skills.
• Flexibility to adapt to new tools, processes, and team dynamics.
• Experience in a start-up environment is a plus.
• Fluency in Spanish is preferred.

Originally posted on Himalayas