Committed to improving speech and language outcomes for children and adults with affordable, online therapy.
Patient Access Specialist
Location
PST (UTC-8) + 2 moreAll locations: PST (UTC-8) | MST (UTC-7) | CST (UTC-6)
Posted
11 days ago
Salary
$23 - $26 / hour
Seniority
Mid Level
No structured requirement data.
Job Description
Patient Access Specialist
Expressable
Role Description The Patient Access Specialist provides advanced support across the client journey by independently resolving moderately complex insurance, authorization, billing, and care-readiness issues. This role serves as a knowledgeable resource for escalations, ensures accuracy across workflows that impact client outcomes, and partners closely with internal teams to prevent delays in care. The Specialist also contributes to process improvement, supports onboarding of new team members, and models high-quality standards in documentation, communication, and compliance. What You Would Be Doing at Expressable - Deliver an outstanding, responsive customer experience by supporting patient, family, referral source, and insurance inquiries across phone, email, text, and chat. - Manage high-complexity insurance workflows, including secondary coverage, nuanced benefit structures, and multi-step authorization requirements. - Manage inbound support requests and conduct proactive outreach to collect required documentation, close gaps in care, resolve concerns, schedule client appointments, and improve overall client outcomes. - Verify insurance benefits with accuracy, determine coverage/benefit limits, and ensure timely financial clearance prior to services. - Prepare, submit, and track prior authorizations using appropriate systems; communicate authorization status, issues, and requirements to clinicians, clients, and internal teams. - Support billing and financial inquiries by explaining charges, EOBs, deductibles, copays, payment plans, and financial policies; collect and process payments securely. - Partner closely with clinical, scheduling, and operations teams to ensure accurate treatment plan alignment, session readiness, and continuity of care. - Respond to internal inquiries about the status of in-process cases in a timely manner. - Partner with the Revenue Integrity and Payer Compliance teams to resolve front-end rejections and registration related denials which includes collecting and updating patient billing information to ensure accurate submission/resubmission of claims. - Maintain exemplary documentation quality in CRM/EHR systems, ensuring compliance with HIPAA, PCI, payer rules, and internal policies. - Identify recurring issues or inefficiencies and recommend updates to workflows, job aids, or scripts; support pilots and process-improvement initiatives. - Assist with onboarding and training of new team members by modeling strong communication, documentation, and case management practices. - Manage an independent caseload, consistently meeting SLAs, quality standards, and follow-through expectations across all assigned work. Qualifications - High school diploma or GED required. - Associate’s degree or coursework in healthcare administration, business, or a related field preferred. - 2–3+ years of experience in healthcare operations, patient access, insurance verification, prior authorization, medical billing, or revenue cycle support. - Demonstrated success meeting SLAs and quality metrics in a high-volume environment. - Experience resolving moderately complex payer issues, denied claims, or multi-step client cases. - Prior experience in telehealth or multi-state healthcare environments preferred. - Prior experience working in a fast-paced environment with measurable performance metrics (e.g., SLAs, quality standards). Requirements - Proficiency with EHR/CRM systems and payer portals; ability to navigate multiple systems simultaneously. - Strong data-entry accuracy and documentation discipline. - Working knowledge of insurance terminology (EOBs, COB, medical necessity, visit limits, tiered benefits, etc.). - Ability to recognize workflow issues and recommend improvements. - Strong written and verbal communication skills for both client-facing and internal collaboration. Core Competencies - Advanced Problem-Solving & Case Resolution: Independently resolves moderately complex insurance, billing or care-readiness issues using analytical thinking and informed judgement. Anticipates obstacles and proactively coordinates next steps. - Workflow Ownership & Accountability: Manages a personal caseload with minimal supervision, prioritizing effectively in a fast-paced environment. Ensures accuracy and timeliness in high-volume documentation and operational tasks. - Cross-Functional Collaboration: Works closely with Clinical, Operations and Revenue Cycle staff to address barriers and prevent delays. Influences process improvements through observed trends and consistent communication. - Client Experience Leadership: Models exceptional service and communication standards, including navigating difficult or sensitive conversations with confidence. Provides informal coaching and support to peers. - Compliance & Accuracy Mastery: Demonstrates consistent accuracy in documentation and internal controls, ensuring adherence to HIPAA, PCI and payer requirements. Recognizes and escalates compliance risks early. Benefits - Exceptional paid time off policies that encourage and support life balance, including a winter break. - 401k matching to ensure our staff have what they need to enjoy their retirement. - Health insurance options that ensure well being for the whole person and their family. - Company paid life, short-term disability, and long-term disability coverage. - Remote work environment that strives for connectivity through professional collaboration and personal connections.
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