patient access specialist

Monument Health

Current Employees: Primary Location Rapid City, SD USA Department Scheduled Weekly Hours 40 Starting Pay Rate Range $17.10 - $19.66 (Determined by the knowledge, skills, and experience of the applicant.) Job Summary It starts with heart. That is what you will do each day. As a Patient Access Specialist I at Monument Health, you can begin your healthcare career with no experience necessary. You will be valued as an essential team member providing compassionate patient focused care. You will discover a culture of teamwork, professionalism, mutual respect, and&mdash; most importantly&mdash; a life-changing career. You will make a difference. Every day. As a Patient Access Specialist I, you are responsible for the integrity of all front-end patient access and registration functions including support of excellent patient care and seamless revenue cycle process. You are the first person our patients see each time they enter the facility or department! You are a trusted resource to provide service excellence to all patients, families, physicians, clinicians, and internal departments. Our vision at Monument Health is to be one team, to listen, to be inclusive, and to show we care. To do the right thing. Every time. If you share this philosophy, we hope you&rsquo;ll join us. Monument Health offers competitive wages and benefits on qualifying positions. Some of those benefits can include: *Supportive work culture *Medical, Vision and Dental Coverage *Retirement Plans, Health Savings Account, and Flexible Spending Account *Instant pay is available for qualifying positions *Paid Time Off Accrual Bank *Opportunities for growth and advancement *Tuition assistance/reimbursement *Excellent pay differentials on qualifying positions *Flexible scheduling Job Description Essential Job Functions: Accountable for accurately collecting demographics, confirming patient identity, guarantor assignment, and coverage information and verification from patients or informants including obtaining necessary documents for check-in or admission among various patient settings, utilizing various communication methods (i.e phone, letters, face-to-face, bedside). Assists in achieving the strategic objectives of Monument Health by following Revenue Cycle guidelines. Including participating in quality assurance and improvement activities. Demonstrates knowledge of payer information and benefits, including Medicare, Medicaid, and commercial payers as well as third party liability payers. Performs point of service collections including prepayments, outstanding balances, co-payment and co-insurance; daily reconciliation of cash drawer. Provides patients with basic account reconciliation. Initiates financial clearance by providing patient with cost estimates for scheduled services. Properly escalates financial clearance needs on behalf of the patient. Review and understand authorization and referral records to confirm financial clearance. Educates patient and maintains regulatory compliance as required by distributing and/or obtaining required forms and signatures including consents for treatment and financial agreements, ABN/waivers, and other regulatory forms. Performs business office duties including incoming phone calls and messages, in-basket messaging, patient communications, intra-departmental communications, scanning/faxes, taxi vouchers, mail distribution, lost and found, safe and valuables and other duties as assigned. Provides service excellence including way-finding, reception. Demonstrates the importance of satisfying the needs of the customer by interacting with him/her in a friendly and caring way, being attentive to both emotional and physical needs. Takes responsibility to maintain communication with the customer in order to provide a secure and pleasant experience throughout the system. May obtain referrals and order transcription, as applicable to service area. Perform patient scheduling and check-out, including pre-arrival management for upcoming services per protocols within the supported department, managing and monitoring patient wait lists and recall lists appropriately. Maintain registration related work queues including ongoing resolution of errors. Working knowledge of the electronic medical record: advanced directives, release of information, patient portal proxy forms. Ability to educate patient on the patient basic purpose, and regulations. Address account inquires, resolve or escalate inquiries as appropriate. In order to provide the highest quality of care to our patients, individuals may be required to work beyond normal scheduled shifts and will be required to comply with Monument Health's Attendance Policy. May perform patient movement activities in the electronic medical record. May arrange patient transportation and other enabling services. Assist clinical care team as needed including providing transport in cooperation with clinical team direction. Responsible for attending all mandatory education, compliance and safety program sessions. Required to comply with all current and future policies and procedures and report directly to the supervisor. All other duties as assigned. Additional Requirements Preferred: Education - High School Diploma/GED Equivalent Work Experience - 1+ years Customer Service Experience; 1+ years Patient Relations Experience; 1+ years Medical Patient Accounts/Financial Services Experience Scheduling Requirements: Requires the ability to work assigned schedules and hours as determined by the department. Physical Requirements: Medium work - exerting up to 10 pounds of force constantly (67-100% of the time), and/or up to 25 pounds of force frequently (34-66% of the time), and or up to 50 pounds of force occassionally (up to 33% of the time), and/or up to 50 pounds seldomly to move objects. Possible exposure to blood, bodily fluids, or tissues. Job Category Revenue Cycle Job Family Registration and Scheduling Make a difference . Every day. Monument Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected Veteran status.

Patient Access Specialist

61st Street Service Corporation

<div>Top Healthcare Provider Network
The 61st Street Service Corporation, provides administrative and clinical support staff for ColumbiaDoctors. This position will support ColumbiaDoctors, one of the largest multi-specialty practices in the Northeast. ColumbiaDoctors&rsquo; practices comprise an experienced group of more than 2,800 physicians, surgeons, dentists, and nurses, offering more than 240 specialties and subspecialties.
Job Summary:
The Patient Access Specialist III &ndash; Radiology supports system-wide radiology scheduling, prior authorization, financial clearance, and revenue cycle coordination within a high-volume call center. This lead-level role manages complex imaging appointment workflows (MRI/CR/PET/CT, Ultrasound, Interventional Radiology, and other diagnostic services) while proactively identifying and resolving authorization, insurance, and financial barriers that may delay patient care.
The Specialist serves as a liaison between Radiology, the Clinical Revenue Office (CRO), billing teams, referring providers, and patients to ensure accurate scheduling, financial transparency, and compliance with payer requirements. This role also provides mentorship to team members, supports quality assurance initiatives, and promotes an exceptional patient experience aligned with organizational standards of Service, Trust, Safety, Inclusion and Communication.
Job Responsibilities:
Radiology Scheduling &amp; Authorization Oversight
<ul><li>Schedule complex radiology appointments ensuring correct modality, exam type, provider, and location selection.</li>
<li>Review scheduled imaging appointments to identify prior authorization and financial clearance risks.</li>
<li>Conduct authorization reviews at the time of scheduling and again within 24 hours prior to the scheduled appointment.</li>
<li>Monitor authorization status and ensure peer-to-peer reviews are completed when required.</li>
<li>Cancel and reschedule radiology appointments when authorization or financial clearance cannot be secured prior to date of service, in accordance with departmental guidelines.</li>
<li>Communicate clearly with patients regarding preparation instructions, arrival times, required documentation, and safety precautions.</li>
<li>Escalate complex authorization or payer-related issues to management or CRO as appropriate and track through resolution.</li>
<li>Ensure Workers&rsquo; Compensation and No-Fault radiology cases are properly documented and authorized prior to service</li>
</ul>
Leadership &amp; Operational Support
<ul><li>Serve as liaison between Radiology, CRO, Patient Access, billing teams, and referring providers to resolve complex cases.
</li><li>Mentor and train Patient Access Specialists on radiology scheduling, insurance registration, and authorization workflows.</li>
<li>Assist with quality assurance reviews to ensure scheduling accuracy and financial clearance compliance.</li>
<li>Identify workflow gaps and recommend process improvements to leadership.</li>
<li>Support operational coverage needs and assist management with workflow adjustments.</li>
</ul>
Patient Financial Estimates &amp; Clearance
<ul><li>Support radiology-specific estimate workflows, including:
<ul><li>Authorization-related denials impacting imaging services</li>
<li>High deductible and coinsurance reviews</li>
<li>STAT estimate requests</li>
<li>Patient outreach regarding out-of-pocket responsibility and add-on imaging services</li>
<li>Work Radiology Estimate Workqueues (WQs).</li>
</ul></li><li>Clearly explain patient financial responsibility.</li>
<li>Collaborate with CRO and billing teams to resolve estimate discrepancies and ensure accurate documentation prior to service.</li>
<li>Assess financial risk for appointments not cleared prior to service; independently resolve low-risk cases and escalate high-risk cases as appropriate.</li>
</ul>
Billing &amp; Revenue Cycle Support
Client Account Support - SNF &amp; External Accounts
<ul><li>Support Skilled Nursing Facility (SNF) and contracted radiology accounts following payer denials or recoupments.</li>
<li>Manually bill SNF radiology claims when required and follow up with clients and SHS regarding claim posting and resolution.</li>
<li>Coordinate with referring offices to resolve billing and authorization discrepancies.</li>
</ul>
Payment &amp; Charge Reconciliation
<ul><li>Reconcile radiology payments and payment transfers in coordination with SHS.</li>
<li>Identify and reconcile missing consultation, interpretation, or technical charges.</li>
<li>Assist in resolving charge discrepancies prior to claim submission.</li>
</ul>
Epic Reporting &amp; Charge Capture
<ul><li>Run standard Epic radiology billing reports to support follow-up and reconciliation activities.</li>
<li>Review billing and authorization WQs.</li>
<li>Manually post-placeholder charges when required.</li>
</ul>
Billing Provider &amp; Bill Area Maintenance
<ul><li>Assign correct billing provider to drug codes based on the interpreting/reading radiologist.</li>
<li>Manually update bill areas on claims built by CPT code, provider, and radiology department to ensure accurate claim submission and reporting.</li>
<li>Ensure claims align with appropriate billing structures prior to submission.</li>
</ul>
Job Qualifications:
<ul><li>High School Diploma or equivalent required.</li>
<li>Minimum of 5 years of relevant experience in healthcare scheduling, radiology patient access, authorization, or revenue cycle functions.</li>
<li>Strong knowledge of radiology imaging services, terminology, and payer authorization requirements required.</li>
<li>Demonstrated experience handling complex financial clearance and billing related workflows.</li>
<li>Advanced customer service skills and the ability to maintain a pleasant and helpful demeanor through all situations. Including the ability to maintain a professional demeanor under pressure due to the high volume and urgent nature of calls.</li>
<li>Ability to work independently in a high-volume, fast-paced environment.</li>
<li>Excellent verbal and written communication skills including interpersonal skills. Ability to communicate clearly and concisely and ensure understanding of information by patients and customers.</li>
<li>Intermediate proficiency in Microsoft Office (Word &amp; Excel) or similar software is required and an ability and willingness to learn new systems and programs.</li>
<li>Ability to work collaboratively with a culturally diverse staff and patient/family population, demonstrating tact and sensitivity.</li>
<li>Ability to work independently and follow-through and handle multiple tasks simultaneously.</li>
<li>Must be a motivated individual with a positive and exceptional work ethic.</li>
<li>Associate's Degree or higher preferred.</li>
<li>Prior experience in Radiology, Financial Clearance or Revenue Cycle Operations is preferred.</li>
<li>Customer service experience in a Call Center environment is preferred.</li>
<li>Experience in high-volume ambulatory setting preferred.</li>
<li>Bilingual (English/Spanish) a plus.</li>
</ul>
Hourly Rate Ranges: $30.77 - $36.54
Note: Our salary offers will fall within these ranges based on a variety of factors, including but not limited to experience, skill set, training and education.
61st Street Service Corporation
At 61st Street Service Corporation we are committed to providing our client with excellent customer service while maintaining a productive environment for all employees. The Service Corporation offers a competitive comprehensive Benefit package to eligible employees; including Healthcare and various other benefits including Paid Time off to promote a healthy lifestyle.
We are an equal employment opportunity employer and we adhere to all requirements of all applicable federal, state, and local civil rights laws.</div>

Patient Access Specialist III #Full Time

<div>Current Employees: 
Primary Location
Rapid City, SD USA
Department
MHHVI Cardiac Services
Scheduled Weekly Hours
40
Starting Pay Rate Range
$17.10 - $19.66
(Determined by the knowledge, skills, and experience of the applicant.)
Job Summary
It starts with heart. That is what you will do each day. As a Patient Access Specialist I at Monument Health, you can begin your healthcare career with no experience necessary. You will be valued as an essential team member providing compassionate patient focused care. You will discover a culture of teamwork, professionalism, mutual respect, and&mdash; most importantly&mdash; a life-changing career. You will make a difference. Every day.
 
 
As a Patient Access Specialist I, you are responsible for the integrity of all front-end patient access and registration functions including support of excellent patient care and seamless revenue cycle process. You are the first person our patients see each time they enter the facility or department! You are a trusted resource to provide service excellence to all patients, families, physicians, clinicians, and internal departments.
 
 
Our vision at Monument Health is to be one team, to listen, to be inclusive, and to show we care. To do the right thing. Every time. If you share this philosophy, we hope you&rsquo;ll join us.
Monument Health offers competitive wages and benefits on qualifying positions. Some of those benefits can include:
<ul><li>Supportive work culture
</li></ul><ul><li>Medical, Vision and Dental Coverage
</li></ul><ul><li>Retirement Plans, Health Savings Account, and Flexible Spending Account
</li></ul><ul><li>Instant pay is available for qualifying positions
</li></ul><ul><li>Paid Time Off Accrual Bank
</li></ul><ul><li>Opportunities for growth and advancement
</li></ul><ul><li>Tuition assistance/reimbursement
</li></ul><ul><li>Excellent pay differentials on qualifying positions
</li></ul><ul><li>Flexible scheduling
</li></ul>Job Description
Essential Job Functions:
<ul><li>Accountable for accurately collecting demographics, confirming patient identity, guarantor assignment, and coverage information and verification from patients or informants including obtaining necessary documents for check-in or admission among various patient settings, utilizing various communication methods (i.e phone, letters, face-to-face, bedside).
</li><li>Assists in achieving the strategic objectives of Monument Health by following Revenue Cycle guidelines. Including participating in quality assurance and improvement activities.
</li><li>Demonstrates knowledge of payer information and benefits, including Medicare, Medicaid, and commercial payers as well as third party liability payers.
</li><li>Performs point of service collections including prepayments, outstanding balances, co-payment and co-insurance; daily reconciliation of cash drawer. Provides patients with basic account reconciliation.
</li><li>Initiates financial clearance by providing patient with cost estimates for scheduled services. Properly escalates financial clearance needs on behalf of the patient.
</li><li>Review and understand authorization and referral records to confirm financial clearance.
</li><li>Educates patient and maintains regulatory compliance as required by distributing and/or obtaining required forms and signatures including consents for treatment and financial agreements, ABN/waivers, and other regulatory forms.
</li><li>Performs business office duties including incoming phone calls and messages, in-basket messaging, patient communications, intra-departmental communications, scanning/faxes, taxi vouchers, mail distribution, lost and found, safe and valuables and other duties as assigned.
</li><li>Provides service excellence including way-finding, reception. Demonstrates the importance of satisfying the needs of the customer by interacting with him/her in a friendly and caring way, being attentive to both emotional and physical needs. Takes responsibility to maintain communication with the customer in order to provide a secure and pleasant experience throughout the system.
</li><li>May obtain referrals and order transcription, as applicable to service area.
</li><li>Perform patient scheduling and check-out, including pre-arrival management for upcoming services per protocols within the supported department, managing and monitoring patient wait lists and recall lists appropriately.
</li><li>Maintain registration related work queues including ongoing resolution of errors.
</li><li>Working knowledge of the electronic medical record: advanced directives, release of information, patient portal proxy forms. Ability to educate patient on the patient basic purpose, and regulations.
</li><li>Address account inquires, resolve or escalate inquiries as appropriate.
</li><li>In order to provide the highest quality of care to our patients, individuals may be required to work beyond normal scheduled shifts and will be required to comply with Monument Health's Attendance Policy.
</li><li>May perform patient movement activities in the electronic medical record.
</li><li>May arrange patient transportation and other enabling services.
</li><li>Assist clinical care team as needed including providing transport in cooperation with clinical team direction.
</li><li>Responsible for attending all mandatory education, compliance and safety program sessions.
</li><li>Required to comply with all current and future policies and procedures and report directly to the supervisor.
</li><li>All other duties as assigned.
</li></ul>Additional Requirements
Preferred:
Education - High School Diploma/GED Equivalent
Work Experience - 1+ years Customer Service Experience; 1+ years Patient Relations Experience; 1+ years Medical Patient Accounts/Financial Services Experience
Scheduling Requirements: Requires the ability to work assigned schedules and hours as determined by the department.
 
 
Physical Requirements: Medium work - exerting up to 10 pounds of force constantly (67-100% of the time), and/or up to 25 pounds of force frequently (34-66% of the time), and or up to 50 pounds of force occassionally (up to 33% of the time), and/or up to 50 pounds seldomly to move objects. Possible exposure to blood, bodily fluids, or tissues.
Job Category
Revenue Cycle
Job Family
Registration and Scheduling
Shift
Requires the ability to work assigned schedules and hours as determined by the department
Employee Type
Regular 
 
10 Monument Health Rapid City Hospital, Inc.
Make a difference . Every day.
Monument Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected Veteran status.</div>

Patient Access Specialist I | Cardiology Clinic

Catholic Health System

<div>Facility: Sisters of Charity Hospital St Joseph Campus 
 
Shift: Shift 1 
 
Status: Per Diem FTE: 0.100000 
 
Bargaining Unit: ACE Associates 
 
Exempt from Overtime: Exempt: No 
 
Work Schedule: Days with Weekend and Holiday Rotation 
 
Hours: 7:00am to 3:00pm with every third weekend 
 
Summary: 
 
The Patient Access Specialist is the front line Hospital System liaison with customers, i.e.; patients, physicians, other hospital departments and offsite facilities and registers patients for all in and out patient services. The Patient Access Specialist is responsible to provide access for patients to the Hospital System while ensuring the Hospital or offsite Facilities fulfill its registration, business and administrative requirements related to each patient encounter. 
 
Responsibilities: 
 
EDUCATION 
<ul><li>
High School Graduate/or Equivalent</li></ul> 

EXPERIENCE
 
<ul><li>Minimum 1 year hospital registration or medical office experience required
</li><li>Previous experience or knowledge of Medical Terminology preferred
</li></ul> 
KNOWLEDGE, SKILL, ABILITY 
<ul><li>
Must possess general office skills, including but not limited to computer/keyboarding, fax machines and typing at least 30 wpm and/or demonstrated computer proficiency</li><li>
Knowledge of Microsoft office, Word Perfect, Excel preferred</li><li>
Must Posses excellent/effective communication/interpersonal skills</li><li>
Organizational skills, attention to detail and follow through a must</li><li>
Has the ability to maintain composure when interacting with a wide variety of customers and situations</li><li>
Highly motivated and willing to contribute skills and ideas for the overall improvement of the department</li><li>
Must be flexible and effective in a fast paced/changing healthcare environment</li></ul></div>

Patient Access Specialist Patient Registration SCH SJC

Akron Children's

<div></div><div><h2 class="jobSectionHeader">Job Description</h2>
Job Requisition Number 31897
<div><div>Full-time, 40 Hours/Week</div><div>
Monday - Friday, Day Shift</div><div>
Remote (First 90 days onsite)</div><div></div><div> 
Summary:</div> 
The Authorization Specialist is responsible for obtaining prior authorizations and verifying insurance coverage for pediatric patients. This includes therapy, behavioral health, diagnostic procedures, specialist visits, surgeries, injections, infusion therapies, and advanced radiology services (CT, MRI, PET, and Nuclear Medicine). The specialist plays a critical role in ensuring timely access to care, supporting families in navigating the insurance process, and helping minimize financial barriers to treatment.<div>
Responsibilities:</div> 
<ul><li>
Secure prior authorizations for a variety of pediatric services.</li><li>
Verify insurance eligibility and benefits prior to service; ensure benefits and authorizations are clearly documented in the patient record.</li><li>
Gather, verify, and review the necessary clinical documentation from providers, including medical records, progress notes, lab results, treatment plans, and any other require information to ensure requested services meeting payer medical necessity requirements based on CPT codes provided.</li><li>
Coordinate with clinical and scheduling teams to prevent delays in care caused by pending or denied authorizations.</li><li>
Participate in clinical huddles and team meetings to discuss challenges, share best practices, and contribute to process improvement initiatives.</li><li>
Follow-up with payers to obtain timely approvals and resolve issues related to pediatric-specific criteria (e.g., age-based guidelines, developmental appropriateness).</li><li>
Communicate denied authorizations and next steps to initiate the peer to peer or appeal process, track and manage the outcomes, and escalate any issues.</li><li>
Refer families to Financial Counseling when patient responsibility amounts are identified and provide clear guidance to support caregiver understanding.</li><li>
Maintain accurate records of authorization statuses and payer communications in the EHR.</li><li>
Collaborate with care teams, including case management, to expedite authorizations for urgent services when needed.</li><li>
Meet departmental standards for productivity, accuracy, and timeliness.</li></ul><div>
Other information:</div> 
Technical Expertise<ul><li>
Knowledge of medical terminology, CPT/ICD-10 codes, and pediatric insurance benefits.</li><li>
Strong interpersonal communication skills to support families with empathy and clarity.</li><li>
Ability to navigate multiple systems (EHR, payer portals); Epic experience preferred.</li><li>
Understanding of medical necessity and documentation standards for pediatric services.</li></ul>
Education and Experience<ul><li>
Education: High school diploma or equivalent required; associate degree or healthcare certification preferred.</li><li>
Experience: Minimum 1 year in a Clinical, Revenue Cycle, Patient Access or Insurance company role that perform work related to; prior authorization, insurance verification, billing, scheduling, patient service rep, customer service, etc. required.</li><li>
Pediatric healthcare access roles preferred.</li><li>
Working with pediatric patients, families, or within a children's hospital preferred.</li><li>
Familiarity with pediatric insurance policies, including Medicaid, managed care, and commercial plans preferred.</li></ul><div>
Full Time</div><div></div><div>
FTE: 1.000000</div></div></div>

Authorization Specialist

NORTH MISSISSIPPI HEALTH SERVICES

<div></div><div><h1 class="jobSectionHeader">Specialist-Patient Access</h1>
<div><div><div>Job ID: 000F6C</div>
<div>Tupelo</div>
<div>Administrative Support - SLEEP LAB</div>
<div>Full Time - Day</div>
</div></div><div><h2 class="jobSectionHeader">Posting Description</h2>
<div>We believe a career is more than just a career &mdash; it's a calling. Our teammates' &quot;True North&quot; is what calls them to health care; it&rsquo;s their passion. At North Mississippi Health Services, we believe in helping you leverage and connect that passion with a much greater purpose that impacts people you know and love.
</div></div>
<div><h2 class="jobSectionHeader">Job Description</h2>
<div><div>JOB SUMMARY 
The Patient Access Specialist at North Mississippi Health Services is responsible for supporting the overall financial health of the organization by completing the daily activities of the collecting and input of Insurance Information, Point of Service Collections and Financial Arrangements, &amp; Customer Service via Direct Contact with Patients and their family members. This role operates under the guidance of the Patient Access Manager and requires an experienced individual with excellent analytical, organizational, and communications skills to manage Demographic and Insurance Information. resolve real time edits &amp; denials, and interface effectively wit h internal and externa l stakeholders to promote timely and accurate patient flow and collections. 
 
JOB FUNCTIONS 
Scheduling: 
<ul><li>Responsible for scheduling/rescheduling, pre-certifying, checking medical necessity, and pre-registering patients for appointments, diagnostic tests, and outpatient procedures as ordered by referring providers</li><li>Obtains necessary information required for scheduling, pre-certification, and pre-registration</li><li>Obtains and/or verifies patient demographics, insurance information/eligibility, and benefits</li><li>Responsible for informing patients and/or clinical staff of the proper preparation and instructions for the tests ordered</li><li>Notifies patient of the location of the appointment date &amp; time, test, and/or procedure</li></ul>
Patient Experience: 
<ul><li>Obtains crucial confidential patient identification information including patient records, signatures, and payment information repeatedly and ensures HIPAA guidelines are enforced</li><li>Effectively communicates NMHS&rsquo; organizational revenue cycle and financial policies including estimates, charity plans and payment options to patients and patient representatives</li><li>Provides bedside registration to obtain consent form signatures, collect insurance, and other confidential information pertinent information to ensure accurate medical record data entry that aligns with CMS and other regulatory agencies</li></ul>
Collections &amp; Financial Arrangements: 
<ul><li>Ensures team members are providing estimates to guarantors for elective procedures and collection attempted at the point of pre-registration or point of service</li><li>Ensures team members are administering ABNs when necessary</li><li>Ensures accounts are financially secure prior to service</li><li>Ensures timely and accurate processing of accounts in accordance with best practices, defined workflow, procedures, and applicable legislation/regulations</li></ul>
Denials Management: 
<ul><li>Corrects front end errors real time to minimize denial throughput</li><li>Develops strategy for consistently obtaining accurate, timely, and beneficial patient demographic information</li><li>Review post service denials to assist in developing front end strategies to reduce denial inflow</li><li>Identifies trends and reports potential significant and recurring issues along with possible solutions to leadership</li><li>Takes proactive, corrective action through systematic and procedural development to reduce incoming denials</li></ul>
Contract Management: 
<ul><li>Maintains familiarity with payer methodologies to ensure accurate estimates are communicated with patients &amp; system variances are communicated with leadership</li><li>Manages expected reimbursement to ensure appropriate patient portion is collected prior to service</li><li>Develops strategy for partnering with business office to ensure estimates &amp; transparency are accurate</li><li>Analyzes estimate variances to understand where/why deviations occurred</li><li>Identifies trends and reports potential significant and recurring issues along with possible solutions to leadership</li></ul> 

QUALIFICATIONS 
 
Education</div> 
<ul>
<li> Bachelor's Degree In Business, Healthcare, Coding, or equivalent field. Required</li>
<li> Associate's Degree Willing to consider 4 years Patient Access, Claims, Billing/ Follow-Up, or revenue cycle experience beyond minimum requirement in lieu of Bachelor degree. Required</li>
<li> High School Diploma or GED Equivalent Willing to consider 8 years Patient Access, Claims, Billing/ Follow-Up, or revenue cycle experience beyond minimum requirement in lieu of Bachelor degree. Required 
 
Licenses and Certifications 
 
Work Experience 
</li>
<li>1-3 years</li>
<li>1-3 years 
 
Knowledge Skills and Abilities 
</li>
<li>Working knowledge of Registration systems, Medicare/Medicaid/Third Party Liability/Workers Compensation</li>
<li>Proficient in Microsoft Office (Word, Excel, and Outlook)</li>
<li>Knowledge of applicable state and federal regulations relating to registering accounts and collecting at point of service</li>
<li>Excellent negotiating and analytical skills</li>
<li>Strong verbal and written communication skills</li>
<li>Excellent interpersonal skills</li>
<li>Effectively and efficiently prioritizes and organizes tasks</li>
<li>Develops, implements/evaluates projects (timely &amp; efficient manner)</li>
<li>Ensures accurate and timely collection of all appropriate patient estimates</li>
<li>Ensures effective monetary management of Deposits</li>
<li>Ensures timely and accurate processing of accounts in accordance with best practices, defined workflow, procedures, and applicable legislature/ regulations</li>
<li>Gathers and relays information with knowledge, tact, and diplomacy</li>
<li>Experiences daily contact with co-workers, patients, payers, and other NMHS/NMMC staff members</li>
<li>Exhibits strong written and verbal communication skills</li>
<li>Reflects a positive, caring attitude toward clients, patients, staff, and the public we serve</li>
<li>Evaluates and coaches reporting employees to accomplish major goals and objectives</li>
<li>Develops, implements/evaluates projects in a timely &amp; efficient manner</li>
<li>Effectively communicates information to staff, internal and external customers 
Physical Demands 
 
A thorough completion of this section is needed for compliance with legal standards such as the Americans with Disabilities Act. The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.</li>
<li>Standing. Occasionally</li>
<li>Walking. Occasionally</li>
<li>Sitting. Frequently</li>
<li>Lifting/Carrying. Occasionally 20 lbs</li>
<li>Pushing/Pulling. Rarely</li>
<li>Climbing. Rarely</li>
<li>Balancing. Rarely</li>
<li>Stooping/Kneeling/Bending. Rarely</li>
<li>Reaching/Over Head Work. Occasionally</li>
<li>Grasping. Frequently</li>
<li>Speaking. Frequently</li>
<li>Hearing. Constantly</li>
<li>Repetitive Motions. Frequently</li>
<li>Eye/Hand/Foot Coordinations. Occasionally 
 
Benefits A****vailable</li>
<li>Continuing Education</li>
<li>403B Retirement Plan with Employer Match Contributions</li>
<li>Pet, Identity Theft and Legal Services Insurance</li>
<li>Wellness Programs and Incentives</li>
<li>Referral Bonuses</li>
<li>Employee Assistance Program</li>
<li>Medical Benefits</li>
<li>Dental Benefits</li>
<li>Vision Benefits</li>
<li>License + Certification Reimbursement</li>
<li>Life, Long-Term and Short-Term Disability, Group Accident, Critical Illness and Hospital Indemnity Insurance</li>
<li>Employee Discount Program</li>
<li>Other:</li>
<li>Early Access to Earned Wages</li>
<li>Tuition Assistance</li>
<li>Relocation Assistance</li>
<li>Paid Time Away</li>
<li>Special Employee Rates at NMMC Wellness Centers 
Physical Demands 
 
A thorough completion of this section is needed for compliance with legal standards such as the Americans with Disabilities Act. The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.</li>
<li>Standing. Occasionally</li>
<li>Walking. Occasionally</li>
<li>Sitting. Frequently</li>
<li>Lifting/Carrying. Occasionally 20 lbs</li>
<li>Pushing/Pulling. Rarely</li>
<li>Climbing. Rarely</li>
<li>Balancing. Rarely</li>
<li>Stooping/Kneeling/Bending. Rarely</li>
<li>Reaching/Over Head Work. Occasionally</li>
<li>Grasping. Frequently</li>
<li>Speaking. Frequently</li>
<li>Hearing. Constantly</li>
<li>Repetitive Motions. Frequently</li>
<li>Eye/Hand/Foot Coordinations. Occasionally 
 
Benefits A****vailable</li>
<li>Continuing Education</li>
<li>403B Retirement Plan with Employer Match Contributions</li>
<li>Pet, Identity Theft and Legal Services Insurance</li>
<li>Wellness Programs and Incentives</li>
<li>Referral Bonuses</li>
<li>Employee Assistance Program</li>
<li>Medical Benefits</li>
<li>Dental Benefits</li>
<li>Vision Benefits</li>
<li>License + Certification Reimbursement</li>
<li>Life, Long-Term and Short-Term Disability, Group Accident, Critical Illness and Hospital Indemnity Insurance</li>
<li>Employee Discount Program</li>
<li>Other:</li>
<li>Early Access to Earned Wages</li>
<li>Tuition Assistance</li>
<li>Relocation Assistance</li>
<li>Paid Time Away</li>
<li>Special Employee Rates at NMMC Wellness Centers</li>
</ul></div></div><div><h2 class="jobSectionHeader">Requirements</h2>
<div>No additional requirements from any stated in the above description.
</div></div><div><h3 class="jobSectionHeader">Education</h3>
<div>You must have the following education to apply:
</div>You must have a Bachelors or higher</div></div>

Specialist-Patient Access

Infinx

<div>About Our Company: 
At Infinx, we're a fast-growing company focused on delivering innovative technology solutions to meet our clients' needs. We partner with healthcare providers to leverage automation and intelligence, overcoming revenue cycle challenges and improving reimbursements for patient care. Our clients include physician groups, hospitals, pharmacies, and dental groups. 
We're looking for experienced associates and partners with expertise in areas that align with our clients' needs. We value individuals who are passionate about helping others, solving challenges, and improving patient care while maximizing revenue. Diversity and inclusivity are central to our values, fostering a workplace where everyone feels valued and heard.
A 2025 Great Place to Work&reg;
In 2025, Infinx was certified as a Great Place to Work&reg; in both the U.S. and India, underscoring our commitment to fostering a high-trust, high-performance workplace culture. This marks the fourth consecutive year that Infinx India has achieved certification and the first time the company has earned recognition in the U.S. 
Location: Remote 
 
Summary Description: 
This remote Prior Authorization Specialist supports the Patient Access Onshore department in various functions, insurance verification and coordinating prior authorization requests for medications. This position and is critical in facilitating timely patient access to healthcare by managing prior authorization processes. This role involves contacting payers for benefit information, checking authorization requirements, collecting required documentation, submitting requests to payers, and tracking authorization status. 
 
Daily Responsibilities:<ul><li>
Contacting payers for eligibility and benefit information to include authorization requirements</li><li>
Obtain prior authorizations and pre-certifications</li><li>
Submit complete and accurate authorization requests</li><li>
Follow up and resolve pending authorization requests</li><li>
Maintain documentation of authorization activity</li><li>
Stay current on payer prior authorization requirements</li></ul>
Skills and Education:<ul><li>
High School Diploma or GED</li><li>
Must be able to work from 8am - 5pm Central</li><li>
2 years of experience working in a physician's office, pharmacy, or healthcare facility</li><li>
2 years of experience processing medication prior authorizations (Commercial, Medicare, Medicaid, and marketplace plans)<ul><li>
5 years of experience processing medication prior authorizations preferred</li></ul></li><li>
Strong computer literacy, including Microsoft Office Suite and EMR/EHR systems</li><li>
Ability to read, interpret, and apply medical terminology and clinical documentation</li><li>
Ability to multitask and work effectively in a high-volume, fast-paced, and deadline-driven environment</li><li>
Strong communication skills with the ability to interact with insurance companies via phone, fax, and electronic portals</li><li>
Strong organizational skills and attention to detail</li><li>
Ability to maintain confidentiality and follow HIPAA regulations</li><li>
Problem-solving ability to investigate denials and determine next steps</li><li>
Comfort navigating payer websites and electronic authorization systems</li><li>
Experience with Cerner preferred</li><li>
Medical Assistant or Pharmacy Technician preferred</li></ul> 

Company Benefits and Perks: 
Joining Infinx comes with an array of benefits, flexible work hours when possible, and a genuine sense of belonging to a dynamic and growing organization.<ul><li>
Access to a 401(k) Retirement Savings Plan.</li><li>
Comprehensive Medical, Dental, and Vision Coverage.</li><li>
Paid Time Off.</li><li>
Paid Holidays.</li><li>
Additional benefits, including Pet Care Coverage, Employee Assistance Program (EAP), and discounted services.</li></ul>
If you are a dedicated and experienced Prior Authorization Specialist ready to contribute to our mission and be part of our diverse and inclusive community, we invite you to apply and join our team at Infinx. 

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Prior Authorization Specialist

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