Patient Access Specialist SR

Jupiter Medical Center is reimagining how to restore the community's health and wellness. Award-winning physicians, world-class partnerships and innovative techniques and technology enable Jupiter Medical Center to provide a broad range of services with specialty concentrations in cardiology, oncology, imaging, orthopedics and spine, digestive health, emergency services, lung and thoracic, women's health, weight management and men's health. Our medical center consistently performs in the top 10 percent of hospitals for patient quality and satisfaction and has earned the highest rating in the region for quality of care.

The Patient Access Specialist Senior will be responsible for delivering a dynamic customer experience to all customers and demonstrate a strong commitment to service excellence.

This position serves as support to Jupiter Medical Center's Centralized Scheduling/Pre-Registration/Authorization Department. The position will work with the department leader to identify areas of need and provide support to these areas and functions. The Patient Access Specialist Senior position functionally supports all modalities of insurance verification, pre-registration, and authorization.

• Utilizes electronic scheduling/registration/financial systems, payer's websites, and recorded calls to validate health coverage and benefits in processing approval for medical services.
• Maintains proper documentation in all systems.
• Works closely with Managed Care and understands health insurances rule sets, manuals, and contract language.
• Contact patient's insurance company to verify coverage, initiate authorizations, provide clinical documentation and follow up on previously submitted prior authorizations.
• Process authorizations electronically, utilizing payer portals, fax, or telephone working with the payers to secure authorizations.
• Determines medical necessity for services using medical criteria software.
• Review and verify all insurance plans and confirm patient's eligibility and benefits.
• Document findings and all pertinent information in the notes section of the patient's record and appointment notes in a thorough and clear manner.
• Provides documentation upon request from insurance companies.
• Works well in a team environment to accomplish common tasks to solve problems and enhance the smooth and efficient flow of the practice.
• Answer telephone, responds to questions, directs calls, and documents messages.
• Works cooperatively and provides coverage for responsibilities of co-workers when assigned or as need arises.
• Develops and promotes the use of effective methods of communicating with physicians, managers, peers, trainees, and staff on a regular basis.
• Obtain authorization renewals, verify physician written orders are active, and certification of medical necessity and or detailed written order is in place.
• Contacts and communicates all applicable insurance deductible, co-pay, arrival and procedure information and instructions to the patient prior to arrival.
• Identify patient financial responsibilities and collect applicable payment.
• Maintains the confidentially of patient's records and any related work.
• Performs other duties as assigned.