Patient Access Specialist

At Coastal Horizons, our mission is to provide a continuum of professional services to promote healthier lives, stronger families, and safer communities. We are currently seeking a motivated and passionate Patient Access Specialist to join our dynamic team. If you're looking for an opportunity to make a difference, we invite you to explore the exciting positions available with us.

JOB TITLE: PATIENT ACCESS SPECIALIST

LOCATION: Wilmington, NC

REQUIRED EDUCATIONAL/EXPERIENTIAL QUALIFICATIONS

• High school diploma or GED with 2-3 years experience related to responsibilities specified.
• Knowledge of electronic health care systems, clinical documentation, and standards.
• Familiar with DSM and ICD-10 codes
• Previous experience with identifying insurance benefits and collecting payments
• Knowledge of state funded terminology
• Basic computer skills including Excel
• Strong organizational, problem solving and analytical skills.
• Working knowledge of cash management principles and/or procedures.

POSITION HIGHLIGHTS:

The Patient Access Specialist is responsible for reviewing and verifying client demographic and financial information prior to intake. Responsible for preparing financial agreement, based on information obtained from private insurer, and obtaining client signature. Responsible for coordinating client with appropriate clinician based on client’s funding and clinician availability. Responsible for tracking and submitting authorizations accurately and efficiently to ensure all rendered services are authorized within contractual guidelines and billable.

ADDITIONAL INFORMATION:

• Review client intake paperwork including insurance information to determine mental health benefits; if client is uninsured, determine eligibility for state funding.
• Prepare financial agreements and obtain client signatures.
• Schedule intake appointments with the appropriate clinician.
• Submit enrollments and updates to MCOs.
• Monitor client’s utilization of unmanaged units and notify clinicians when authorization for continued services is needed.
• Review clinical documentation for completeness and submit to MCO for authorization requests.
• Follow up with MCO to determine approval or denial of authorization requests in a timely manner and effectively communicate with clinician.
• Work directly with MCO and private insurances.
• Excellent interpersonal and communication skills, possesses experience and competency in customer relation skills.

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  Coastal Horizons

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