Access Specialist | Patient Access Representative

Access Specialist | Patient Access RepresentativeJoin a compassionate healthcare team in the Midwest region as a Patient Access Representative, where your role is vital in ensuring smooth patient intake and insurance verification processes. You will be responsible for identifying insurance coverage, obtaining necessary pre-certifications, and assisting with referral data entry to support positive patient and agency outcomes.Essential FunctionsVerify insurance eligibility and benefits accurately.Obtain pre-certifications and ongoing authorizations from various insurance providers.Assist with intake and referral processes, ensuring timely responses to patient needs and optimal staffing utilization.Maintain up-to-date knowledge of federal, state, and private reimbursement regulations, including CMS guidelines.Participate in insurance and regulatory audits and data submissions.Facilitate compliance with certification, PPOC, and Face to Face requirements.Audit admissions and patient records for program-specific conditions and quality reporting.Complete pre-billing and performance improvement chart audits as assigned.Document accurately and timely according to agency policies.Promote effective communication and cooperation with physicians, staff, and clients to ensure reimbursement success.Support billing processes including generation and transmission of notices of election and admission.Perform clerical duties such as managing phone calls and processing incoming faxes.Adhere strictly to HIPAA privacy and security regulations regarding Protected Health Information (PHI).Minimum Knowledge and SkillsAdvanced computer skills with proficiency in medical record systems.Effective communication abilities.Intermediate knowledge of Microsoft Office suite.Strong keyboarding, filing, data processing, and general office skills.Preferred Behavioral SkillsIntegrity: Demonstrates honesty and a commitment to ethical behavior.Compassion: Exhibits empathy and excellent customer service.Accountability: Takes ownership of projects and adapts flexibly to changing priorities.Respect: Collaborates effectively with diverse populations and maintains a positive service orientation.Excellence: Communicates clearly and upholds high standards in service delivery.Education and ExperienceMinimum: High School Diploma.Preferred: Associate's or Bachelor's Degree in Health Care or Business.Preferred experience includes medical terminology, medical office work, and insurance authorization.Licenses and CertificationsRequired: Valid driver's license and proof of auto liability insurance.This role offers competitive pay and a generous benefits package, providing a meaningful opportunity to contribute to quality patient care in a supportive environment.