Access Coordinator | Certified Healthcare Access Associate (CHAA)
MLee Healthcare Staffing and Recruiting, Inc
Job Description
Access Coordinator | Certified Healthcare Access Associate (CHAA)
Linden, NC $41,089 - $52,099 a year
Full Time
Join a dedicated healthcare team as an Access Coordinator, where you will play a vital role in managing patient referrals and ensuring smooth clinical and financial clearance. This full-time day position involves verifying demographic, clinical, financial, and insurance information, as well as validating medical necessity for Medicare and non-Medicare cases. You will be responsible for processing signed physician orders and referrals, maintaining accurate clinical documentation, and coordinating specialty and outpatient ancillary referrals.
Key Responsibilities:
Maintain comprehensive knowledge of referral processes and medical administrative procedures, including handling protected patient information.
Perform insurance eligibility and benefit verification using various tools, ensuring authorizations align with requested services.
Validate medical necessity through LMRP/LCD reviews to guarantee clinical and financial clearance.
Obtain specialist contact details, print orders and patient demographics, and document appropriately in the electronic health record (EHR).
Determine referral requirements and limitations, including emergent referrals.
Pre-register patients for upcoming visits and communicate referral approvals or denials to patients and guarantors.
Confirm appointments with referring offices and patients, providing necessary preparation instructions.
Complete follow-up protocols for routine and urgent referrals as directed by leadership.
Assist insurance companies, physicians, and hospital departments with patient information in compliance with HIPAA guidelines.
Meet or exceed accuracy standards set by Patient Access Leadership.
Education and Experience:
Registered or Certified Medical Office Assistant, or 2-4 years of direct referral experience in lieu of certification.
Licensed Practical Nurse background preferred.
Medical terminology knowledge required.
2-4 years of insurance/referral experience in a hospital or medical office setting preferred.
Skills and Abilities:
Successful completion of pre-employment and post-training testing.
Pass and maintain Certified Healthcare Access Associate (CHAA) certification within one year of employment.
Strong knowledge of insurance processes and payment collection.
Proficiency with Microsoft software.
Excellent verbal and written communication, customer service, and problem-solving skills.
Ability to manage complexity and stress while adapting to changing patient and organizational needs.
Flexibility to work department hours, including possible shift rotations.
Physical Requirements:
Effective oral communication and sensory abilities to collect information.
Dexterity to operate office equipment and extensive computer use.
Ability to lift and move files and materials up to 50 pounds occasionally.
Work environment noise level is low to moderate.
This role is based in a regional healthcare setting serving the Southeastern United States, offering a collaborative and patient-centered work environment.
Linden, NC $41,089 - $52,099 a year
Full Time
Join a dedicated healthcare team as an Access Coordinator, where you will play a vital role in managing patient referrals and ensuring smooth clinical and financial clearance. This full-time day position involves verifying demographic, clinical, financial, and insurance information, as well as validating medical necessity for Medicare and non-Medicare cases. You will be responsible for processing signed physician orders and referrals, maintaining accurate clinical documentation, and coordinating specialty and outpatient ancillary referrals.
Key Responsibilities:
Maintain comprehensive knowledge of referral processes and medical administrative procedures, including handling protected patient information.
Perform insurance eligibility and benefit verification using various tools, ensuring authorizations align with requested services.
Validate medical necessity through LMRP/LCD reviews to guarantee clinical and financial clearance.
Obtain specialist contact details, print orders and patient demographics, and document appropriately in the electronic health record (EHR).
Determine referral requirements and limitations, including emergent referrals.
Pre-register patients for upcoming visits and communicate referral approvals or denials to patients and guarantors.
Confirm appointments with referring offices and patients, providing necessary preparation instructions.
Complete follow-up protocols for routine and urgent referrals as directed by leadership.
Assist insurance companies, physicians, and hospital departments with patient information in compliance with HIPAA guidelines.
Meet or exceed accuracy standards set by Patient Access Leadership.
Education and Experience:
Registered or Certified Medical Office Assistant, or 2-4 years of direct referral experience in lieu of certification.
Licensed Practical Nurse background preferred.
Medical terminology knowledge required.
2-4 years of insurance/referral experience in a hospital or medical office setting preferred.
Skills and Abilities:
Successful completion of pre-employment and post-training testing.
Pass and maintain Certified Healthcare Access Associate (CHAA) certification within one year of employment.
Strong knowledge of insurance processes and payment collection.
Proficiency with Microsoft software.
Excellent verbal and written communication, customer service, and problem-solving skills.
Ability to manage complexity and stress while adapting to changing patient and organizational needs.
Flexibility to work department hours, including possible shift rotations.
Physical Requirements:
Effective oral communication and sensory abilities to collect information.
Dexterity to operate office equipment and extensive computer use.
Ability to lift and move files and materials up to 50 pounds occasionally.
Work environment noise level is low to moderate.
This role is based in a regional healthcare setting serving the Southeastern United States, offering a collaborative and patient-centered work environment.