UNKNOWN

FEED

This role is critical in facilitating timely patient access to care by verifying eligibility and benefits, coordinating authorizations, assisting with patient financial programs, and supporting accurate billing and check-out processes. Legacy Staffing is seeking a detail-oriented and service-focused Patient Access Specialist on behalf of a confidential healthcare client.

YEAR

<h2>Job Title: Patient Access Specialist</h2>Location: Kern County, CA Employment Type: Full-Time/Temp Assignment with the potential to be hired on Compensation: $21 as a temp, pay increase if hired on <h3>Position Overview</h3>Legacy Staffing is seeking a detail-oriented and service-focused Patient Access Specialist on behalf of a confidential healthcare client. This role is critical in facilitating timely patient access to care by verifying eligibility and benefits, coordinating authorizations, assisting with patient financial programs, and supporting accurate billing and check-out processes. The ideal candidate thrives in a fast-paced healthcare environment and demonstrates strong communication, problem-solving, and organizational skills. <h3>Key Responsibilities</h3><h4>Patient Access & Eligibility</h4><ul><li>Verify eligibility and benefits for scheduled and same-day patient appointments</li><li>Resolve registration, eligibility, and authorization issues prior to patient visits</li><li>Coordinate with health plans to assist patients in selecting or transferring to an appropriate primary care provider</li><li>Obtain prior authorizations for services and procedures when required</li></ul><h4>Billing & Check-Out Support</h4><ul><li>Ensure all required billing and authorization information is collected before patient checkout</li><li>Post charges for completed encounters at checkout</li><li>Review daily error reports and correct identified issues prior to patient appointments</li><li>Update patient accounts with pertinent billing and eligibility information</li></ul><h4>Patient Support & Coordination</h4><ul><li>Assist patients in identifying appropriate financial assistance programs based on eligibility</li><li>Coordinate patient financial needs with leadership, scheduling teams, and patient navigators</li><li>Research and clarify documentation with providers or clinical staff as needed</li><li>Maintain effective working relationships with providers, leadership, and operational teams</li></ul><h4>Additional Duties</h4><ul><li>Perform other related duties as assigned by billing or operational leadership</li></ul><h3>Compliance & Organizational Participation</h3><ul><li>Maintain strict HIPAA compliance and confidentiality of patient information</li><li>Ensure compliance with all applicable local, state, and federal healthcare regulations</li><li>Participate in Quality Assurance / Quality Improvement (QA/QI) initiatives</li><li>Learn and effectively utilize Electronic Health Record (EHR) and Practice Management Systems</li><li>Participate in patient-centered care models consistent with organizational policies</li></ul><h3>Qualifications, Education & Experience</h3><ul><li>High school diploma or GED required</li><li>Minimum of two (2) years of experience in billing and accounts receivable within a healthcare environment</li><li>Working knowledge of coding rules, billing regulations, and third-party payer requirements preferred</li><li>Strong customer service skills and professional demeanor when interacting with patients, staff, and external partners</li></ul><h3>Required Skills & Competencies</h3><ul><li>Ability to work efficiently in a fast-paced, high-pressure environment</li><li>Strong multitasking, organizational, and follow-through skills</li><li>Effective verbal, written, and interpersonal communication skills</li><li>Ability to problem-solve and make decisions in alignment with organizational policies</li><li>Ability to work independently while maintaining accountability</li><li>Understanding of community-based organizations and healthcare services</li><li>Ability to engage respectfully with individuals from diverse cultural, ethnic, religious, and economic backgrounds</li></ul><h3>Reporting Relationship</h3><ul><li>Reports to Billing or Revenue Cycle Leadership</li></ul>

Legacy Staffing

Patient Access Specialist

Accounts Receivable

Billing

Communication Skills

Customer Support/Service

Detail Oriented

Diversity

Documentation

Federal Laws and Regulations

Follow Through

HIPAA (Health Insurance Portability and Accountability Act)

Health Plan

Healthcare

High School Diploma

Identify Issues

Interpersonal Skills

Leadership

Maintain Compliance

Medical Billing

Medical Record System

Multitasking

Organizational Skills

Patient Care

Patient Confidentiality

Primary Care

Problem Solving Skills

Quality Assurance

Quality Management

Quality of Care

Regulations

State Laws and Regulations

Third-Party Payer

Time Management

Writing Skills

Manatal

OTHER

Ability to practice autonomously in a remote clinical environment, including independently conducting patient assessments, formulating evidence-based treatment plans, managing complex chronic conditions, and making soundclinical decisions without direct on-site supervision. Pay Range: $2,400.00 - $10,000.00 per month (Potential income) Earnings will vary based on completed assessments, state of residence, and business needs as there is no guarantee of visits or minimum income.

Overview:
Nurse Practitioner Per DiemThis position covers all zip codes in: Kern County-Northwest,  CA ComplexCare Solutions (CCS) specializes in helping those in need by delivering high-value home and virtual assessments for health plans nationwide. We pride ourselves on our member engagement aimed towards evaluating current health status, gaps in care, potential health risks and care management opportunities with a focus on driving better clinical outcomes. CCS, on behalf of SME Medical Delaware, P.A., is calling on Advanced Practice Providers that are passionate about helping their local communities. We care dearly about those whom we serve, and we need your help to make a difference in the lives of our members. Providers have the opportunity to spend a full hour with these members, which allows them to capture a comprehensive picture of that individual’s personal needs and what is required to keep them in the home and out of the hospital. <div class="x_x_elementToProof">Compensation:<ul><li style="margin:0in">Pay Range: $2,400.00 - $10,000.00 per month (Potential income) Earnings will vary based on completed assessments, state of residence, and business needs as there is no guarantee of visits or minimum income</li><li style="margin:0in">In-home visit rate: $120 - $140 depending on state of residence</li><li style="margin:0in">If available, our telehealth rate is $85 per completed assessment</li></ul></div>Benefit:This position is eligible to participate in a company 401K plan providing the opportunity to save for retirement through employee contributions. New hires will be automatically enrolled in the company 401(k) plan at a 3% contribution rate with the option to opt out.

Responsibilities:
<ul><li>Knowledge of CMS Regulations and NCQA HEDIS Guidelines</li><li>Knowledge of Evidence-based Clinical Practice Standards: American Diabetes Association (ADA), American College of Cardiology (ACC), American Heart Association (AHA), Familiarity with ICD-10 and CPT-4 coding practices</li><li>Complete comprehensive, accurate and thorough review of the assigned member population, including timely completion and submission of all required encounter documentation (paper or electronic)</li><li>Ensure that all pertinent and active medical conditions are documented in the medical record in a manner compliant with CMS/DHHS, Company policy, and client requirements</li><li>Support the physician/patient relationship and ensure timely and adequate communication, documentation of assessment findings, recommendations, need for additional services, emergency services required if necessary and need for follow up and timelines for follow up to primary care provider (PCP) and health plan as required</li><li>Make general recommendations to members intended to improve members' knowledge of their chronic condition(s), such as information concerning recommended testing</li><li>Address and close identified gaps in care (disease-specific or preventive)</li><li>Recognize emergent or urgent situations requiring escalation and take appropriate action as specified in company policies, and as determined by reasonable professional judgment and ethical professional practice standards; and</li><li>Perform, document and communicate results of Point of Care (POC) Testing</li><li>Maintain compliance with Company policies, procedures and mission statement</li><li>Adhere to all confidentiality and HIPAA requirements as outlined within the Company’s Operating Policies and Procedures in all ways and at all times with respect to any aspect of the data handled or services rendered in the undertaking of the position</li><li>Fulfill those responsibilities and/or duties that may be reasonably provided for the purpose of achieving operational and financial success of the Company</li><li>Uphold responsibilities relative to the separation of duties for applicable processes and procedures within your job function</li><li>On a monthly basis, be available for a minimum of 25 slots of availability per month (approximately 37 hours)</li><li>We reserve the right to change this job description from time to time as business needs dictate and will provide notice of such</li><li>Other duties as assigned</li></ul>

Qualifications:
<ul style="margin-top:0in"><li>Active un-encumbered license to practice nursing</li><li>ANCC or AANP board certification as a Nurse Practitioner or Clinical Nurse Specialist in Family, Adult, Gerontology or Emergency Medicine. </li><li>Maintains current CPR certification</li><li>Compliance, prior to hire, with recommended Healthcare Personnel Requirements for vaccinations and preventive testing:</li><li><ul style="margin-top:0in"><li>Hepatitis B</li><li>Influenza</li><li>MMR: Measles, Mumps and Rubella</li><li>Pertussis, Tetanus and diphtheria and acellular pertussis (Tdap)</li><li>Varicella</li><li>Tuberculosis</li></ul></li><li>Home Health exp a plus </li><li>Must be able to effectively communicate with elderly and chronically ill patients and families</li><li>Understanding of Medicare, Medicaid and Health Plan benefit structures beneficial</li><li>Ability to multitask</li><li>Excellent customer service skills</li><li>Bi-lingual or multi-lingual a plus</li><li>Ability to practice autonomously in a remote clinical environment, including independently conducting patient assessments, formulating evidence-based treatment plans, managing complex chronic conditions, and making soundclinical decisions without direct on-site supervision</li><li>Proficient with computer platforms, electronic health records (EHRs), secure messaging systems, and cloud-based documentation tools</li></ul>This company utilizes E-Verify. ComplexCare Solutions (CCS) is proud to be an equal opportunity workplace and is an affirmative action employer. We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity or Veteran status. By embracing diversity, equity and inclusion we enhance our work environment and drive business success. ComplexCare Solutions (CCS) strives to reflect the diversity of the communities where we operate and of our clients and everyone whom we serve. We endeavor to create a culture of inclusion in which our associates feel empowered to bring their full, authentic selves to work and pursue their professional goals in an equitable setting. We understand that by fostering this type of culture, and welcoming different perspectives, we generate innovation and growth.

ComplexCare Solutions

Nurse Practitioner (Per Diem)

American Nurses Credentialing Center (ANCC)

CPR Certification

Cardiology

Centers for Medicare and Medicaid Services (CMS)

Certified Coding Specialist (CCS)

Clinical Nursing

Clinical Outcomes

Clinical Practices/Protocols

Cloud Computing

Computer Skills

Computer Systems

Content Management Systems (CMS)

Corporate Policies

Current Procedural Terminology (CPT)

Department of Health and Human Services

Diabetes

Disease

Emergency Medicine

Emergency Services

Equal Employment Opportunity (EEO)

Healthcare Effectiveness Data and Information Set (HEDIS)

Hepatitis B

Home Care

Hospital

ICD-10

Medicaid

Medical Conditions

Medical Records

Medicare

Messaging Technology

Multilingual

National Committee for Quality Assurance (NCQA)

Nurse Practitioner

Nursing Credentials

Operations Processes

Patient Assessment

Risk Management

Staff Requirements

Telehealth

Treatment Plan

[AW]-iCims

Coding jobs in Bakersfield, CA on your radar? Find the best of them right here on Monster.

The Best Coding Jobs in Bakersfield, CA | Monster

Coding Jobs in Bakersfield, CA

Jobs

Resume Resources

Get noticed by top employers!

Coding Jobs in Bakersfield, CA

Jobs

Patient Access SpecialistLegacy Staffing

Nurse Practitioner (Per Diem)ComplexCare Solutions

Resume Resources