Brault logo
Brault

Practice Solutions with a Clinical Edge

Patient Access Specialist

Location

United States

Posted

1 day ago

Salary

$17 - $20 / hour

Seniority

Mid Level

No structured requirement data.

Job Description

Patient Access Specialist

Brault

Role Description This position is responsible for reviewing, verifying, and filling in missing registration/insurance information on encounters received electronically. The role applies and/or corrects billing details based on insurance carrier requirements and established departmental and company policies and procedures. - Manages multiple client accounts according to assigned volume and established productivity expectations. - Routinely monitors and reports low volumes, missing dates of service, and encounters lacking required insurance or payer information. - Uses the RICA coding application and AthenaIDX to update and correct demographic records based on hospital/client data, resolving demographic, insurance, and Patient Access–related errors, edits, and rejections. - Conducts necessary verification checks and assigns accurate payer information to support timely billing and maintaining a minimum accuracy rate of 95% in accordance with departmental and company policies. - Takes ownership of Level 2 escalations from the offshore team, identifies and resolves issues preventing claim submission, and provides feedback or trending observations to the PA & EDI Supervisor for follow-up. - Processes work within 2 business days from the date the work became available; notifies supervisor when not on target. - Completes daily production records accurately and on time. - Communicates any deviations from established workflows and escalates issues that impact daily submission or month-end close. - Consistently communicates with others with respect, kindness, and understanding; is honest and clear; treats sensitive information confidentially; is perceived as positive and demonstrates quality services. - Collaborates with internal teams (Billing, Coding, Enrollment, EDI, Leadership) when clarification or cross-departmental support is required. - Participates in ongoing training, updates, and process improvements, ensuring compliance with evolving payer guidelines and internal workflows. - Performs other related duties as assigned. - Adheres to all Company policies and procedures (i.e. Administrative and Human Resources), practices safe work habits, and maintains high business standards. Qualifications - Strong attention to detail and accuracy, with the ability to identify discrepancies in demographic and insurance information. - Ability to interpret eligibility files and understand payer requirements, rules, and coverage limitations. - Knowledge of insurance types, payer hierarchy, and coordination of benefits. - Ability to work independently with minimal supervision, manage pressure, and meet established deadlines. - Computer literacy and proficiency with Microsoft Office (Excel required). - Excellent communication skills for collaboration with internal teams and external partners. - Ability to prioritize work and manage competing tasks. - Understanding of HIPAA and handling of Protected Health Information (PHI). - Critical thinking and problem-solving abilities to identify root causes of errors and determine appropriate corrective actions. Requirements - Requires High School Graduate or GED. - Minimum of one year in the healthcare industry. - Experience with Athena IDX a plus. - Preferred Insurance data entry / Medical Front office training and/or Certification. Supervisory Responsibilities - No Supervisory Responsibilities.

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