Position Summary
The Pre Access Specialist II is responsible for accurate and complete insurance verification, authorization, and complete pre-registration of all scheduled Diagnostic, Surgical, Audiology and/or Rehabilitation visits. The position works within the EMR using an automated insurance verification tool along with payer websites and documents within the EMR.
Position Duties
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Obtains insurance verification and benefits using an automated verification tool, insurance carrier websites, or by phone. Prepares an estimate for scheduled service and notifies the patient/guarantor of any applicable out of pocket and requests payment if applicable. Accurately documents all information in the appropriate fields and or/account notes.
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Obtains all necessary authorizations for Diagnostic, Surgical, Audiology and/or Rehabilitation visits and accurately documents all information in the appropriate fields and/or account notes.
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Organizes, prioritizes and reviews daily work activity to ensure completion of assigned workload.
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Courteously answers telephone and/or emails and answers all questions in a timely manner. Maintains a positive working relationship with patients/guarantors, insurance companies, clinical personnel, co workers, and management to promote teamwork, cooperation, and a positive public image for Phoenix Children's.
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Participates in a variety of unit and hospital educational programs to maintain current skill and competency levels.
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Performs miscellaneous job related duties as requested.
Phoenix Children's Mission, Vision, & Values
Mission
To advance hope, healing and the best healthcare for children and their families
VisionPhoenix Children's will be the leading pediatric health system in the Southwest, nationally recognized for exceptional care, innovative research and advanced medical education.
We realize this vision by:
- Offering the most comprehensive care across ages, communities and specialties
- Investing in innovative research, including emerging treatments, tools and technologies
- Advancing education and training to shape the next generation of clinical leaders
- Advocating for the health and well-being of children and families
- We place children and families at the center of all we do
- We deliver exceptional care, every day and in every way
- We collaborate with colleagues, partners and communities to amplify our impact
- We set the standards of pediatric healthcare today, and innovate for the future
- We are accountable for making the highest quality care accessible and affordable
Position Qualifications
Education |
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|---|---|
| 1. |
Associates in Business or related field OR an equivalent combination of education and experience.
Required |
Experience |
|
|---|---|
| 1. |
Experience with EMR, document management/imaging system, or Payer websites platform.
Required |
| 2. |
One (1) year of experience requesting Professional/Clinic or Hospital Authorizations
Required |
| 3. |
Experience reviewing and discussing out of pocket liability to patients/guarantors.
Required |
| 4. |
One (1) year of customer service experience
Required |
| 5. |
Knowledge base and experience with CPT codes, J Codes, and ICD Codes.
Required |
| 6. |
One (1) year of medical registration or scheduling experience.
Preferred |
Special Skills |
|
|---|---|
| 1. |
Must be able to work independently and effectively in a high-volume, fast paced environment with changing priorities. Must possess customer-focused attitude and professional demeanor.
Required |
| 2. |
Excellent communication skills (Written and Oral).
Required |
| 3. |
Knowledge of Medical Terminology and an understanding of HIPAA Privacy Laws.
Required |
| 4. |
Analytical skills with strong attention to detail and a high degree of accuracy.
Required |
| 5. |
Proficiency with computer based systems.
Required |
| 6. |
Bilingual (Spanish)
Preferred |
| 7. |
Follow any payer or governmental requirement as required by the organization.
Required |
Physical Requirements & Occupational Exposure/Risk Potential
| 1. | Physical Requirement - Climbing - Occasionally |
| 2. | Physical Requirement - Feeling (sensing textures and temperatures) - Occasionally |
| 3. | Physical Requirement - Fine Motor Skills (pinching, gripping, etc) - Frequently |
| 4. | Physical Requirement - Hearing - Frequently |
| 5. | Physical Requirement - Pushing/pulling - Occasionally |
| 6. | Physical Requirement - Reaching - Occasionally |
| 7. | Physical Requirement - Sitting - Constantly |
| 8. | Physical Requirement - Standing - Occasionally |
| 9. | Physical Requirement - Stooping/crouching/kneeling/crawling - Occasionally |
| 10. | Physical Requirement - Talking - Constantly |
| 11. | Physical Requirement - Tasting/smelling - Occasionally |
| 12. | Physical Requirement - Walking - Occasionally |
| 13. | Physical Requirement - Near Vision - Frequently |
| 14. | Physical Requirement - Far Vision - Frequently |
| 15. | Physical Requirement - Color Discrimination - Occasionally |
| 16. | Physical Requirement - Use of keyboard, mouse and/or computer equipment - Constantly |
| 17. | Physical Requirement - Lift up to 35 pounds without assistance - Occasionally |
| 18. | Physical Requirement - Lift more than 35 pounds without assistance - Occasionally |
Associate's degree in business or related field or equivalent; experience with EMR, document management, or payer websites; 1+ year authorization experience; 1+ year customer service; knowledge of CPT, J, ICD codes; medical terminology and HIPAA; computer proficiency.
Key Responsibilities
- verifying insurance
- obtaining authorizations
- documenting patient information
Skills & Tools
EMR, document management system, payer websites
Job Details
- Category: Healthcare Services - Allied Health
- Seniority: Entry Level
- Commitment: Full Time
- Workplace: Remote — United States
- Languages: English
About Phoenix Children's
A pediatric health system providing comprehensive care, research, and education for children and families. — Industry: Healthcare