Location:United States | Remote
Location Eligibility:Candidates must currently reside in the United States. This role is not available to residents of California, New Jersey, New York, Montana, Hawaii, or Alaska, or of any U.S. territory.
Summary
The Patient Access Concierge independently manages a broader range of patient access activities, including patient registration, insurance verification, appointment scheduling, and prior authorizations, with minimal oversight.
You will serve as a knowledgeable resource for patients, providers, clients, and newer team members, resolving more advanced insurance and scheduling issues and helping spot opportunities to improve workflows. This role suits someone who has mastered the fundamentals and is ready to work with greater independence, take on more complex cases, and begin informally mentoring others.
Responsibilities
Patient Registration
- Accurately collect, verify, and maintain patient demographic, insurance, and clinical information.
- Review patient accounts for completeness and resolve registration discrepancies prior to scheduled services.
- Ensure all required documentation is complete and accurately recorded.
Insurance Verification and Prior Authorizations
- Verify insurance eligibility, benefits, referrals, and authorization requirements across a variety of payer types.
- Obtain, monitor, and document prior authorizations and referrals while ensuring payer requirements are met.
- Investigate and resolve complex insurance eligibility, authorization, and coverage issues independently.
- Communicate authorization requirements, financial responsibility, and coverage concerns to patients, providers, and internal stakeholders.
Scheduling and Customer Service
- Schedule, reschedule, and coordinate appointments while following client and provider scheduling guidelines.
- Serve as a point of contact for escalated patient, provider, and client inquiries.
- Deliver exceptional customer service while resolving complex scheduling and patient access issues.
- Build collaborative relationships with provider offices, insurance carriers, and internal departments to support timely patient care.
Documentation and Compliance
- Maintain complete, accurate, and timely documentation within all assigned systems.
- Ensure compliance with HIPAA, client requirements, payer guidelines, and organizational policies.
- Identify documentation or workflow issues and take appropriate corrective action.
Operational Excellence
- Meet and exceed established productivity, quality, attendance, and service expectations, along with all other relevant team metrics.
- Assist with onboarding and training of new team members by sharing knowledge and best practices.
- Identify workflow inefficiencies and recommend process improvements that enhance operational performance.
- Adapt to changing payer requirements, client expectations, and operational priorities.
- Participate in departmental meetings, quality initiatives, and continuous improvement efforts.
- Perform other duties as assigned.
Qualifications and Experience
- High School Diploma or GED required.
- One to four years of Patient Access, Medical Scheduling, Registration, or related healthcare experience required.
- Demonstrated ability to independently verify insurance eligibility, obtain prior authorizations, and manage appointment scheduling.
- Experience resolving moderately complex insurance, authorization, or patient access issues with minimal guidance.
- Experience using electronic medical record (EMR) systems such as Epic or Cerner preferred.
- Working knowledge of commercial insurance, Medicare, Medicaid, and managed care plans.
- Excellent customer service, communication, organizational, and problem solving skills.
- Proficiency with Microsoft Office and web based healthcare applications.
- Ability to manage multiple priorities while maintaining a high level of accuracy and professionalism.
- Ability to work independently in a remote environment with limited day to day oversight.
Physical Demands and Working Conditions
- Fully remote, U.S. based position.
- Requires reliable high speed internet and a private, quiet, and focused workspace that protects patient confidentiality.
- Prolonged sitting while working at a computer and using a telephone or headset.
- Clear, professional communication with patients, providers, and colleagues in every interaction.
- High volume of calls and inquiries, including phone-based communication for up to 8 hours per day.
- Frequent typing and data entry across multiple software applications.
- Continuous communication with patients, providers, insurance carriers, clients, and internal team members.
- Occasional overtime may be based on business needs.
Benefits
- FLSA Classification: Non-Exempt
- Benefits Offered:
- Employer sponsored Medical, Dental & Vision
- Employer Paid Life, Short-term and Long-term Disability, and AD&D Insurance Plans
- Flexible Time Off Plan & Paid Holidays
- Employee Referral Bonus