Building Location:
Fargo Distribution Serv Center
Department:
1007190 PRE-SERVICE AUTHORIZATION - EH SS
Job Description:
The Access Coordinator gathers necessary insurance information and uses expertise to translate the information provided by the patient/guarantor into the computer system, resulting in accurate claim submissions.
Education Qualifications:
Key Responsibilities:
Prepares and submits payer-specific prior authorizations and referrals in alignment with relevant guidelines and medical policy criteria
Accurately identifies required insurance verification and medical documentation in accordance with payer policy
Collaborates with clinicians and medical practitioners to obtain all necessary information for successful authorization approval
Thoroughly documents all interactions and actions related to insurance processes within the electronic Medical Record (EMR) system
Regularly reviews and monitors assigned work queues, identifying, and focusing on accounts with the highest financial reimbursement risk
Adapts to urgent clinical needs while maintaining high-quality work outputs within specified timelines
Communicates with patients as needed to facilitate medical clearance
Develops pre-service estimates and supports pre-service collections
Supports the review of prior authorization requests that do not initially meet criteria and works collaboratively with relevant stakeholders to resolve issues or coordinate necessary clinician-to-health plan interventions
Required Qualifications:
Preferred Qualifications:
Licensure/Certification Qualifications:
FTE:
1
Possible Remote/Hybrid Option:
Remote
Shift Rotation:
Shift Start Time:
Shift End Time:
Weekends:
Holidays:
No
Call Obligation:
No
Union:
Compensation Range:
$17.63 - $26.45
Employee Benefits at Essentia Health:At Essentia Health, we're committed to supporting your well-being, growth, and work-life balance. Our comprehensive benefits include medical, dental, vision, life, and disability insurance, along with supplemental options to fit your needs. We offer a 401(k) plan with employer contributions to help you plan for the future, and we invest in your professional development through training, tuition reimbursement, and educational programs. To help you thrive both at work and at home, we provide flexible scheduling, generous time off, and wellness resources focused on your physical, mental, and emotional health. Please note that benefit eligibility may vary. For full details, refer to your benefit summary or contact our HR Service Center at (218) 576-0000.
It is our policy to afford EEO to all individuals, regardless of race, religion, color, sex, pregnancy, gender identity, national origin, age, disability, family medical history, genetic information, sexual orientation, marital status, military service or veteran status, culture, socio-economic status, status with regard to public assistance, and other factors not related to qualifications, including employees or applicants who inquire about, discuss, or disclose their compensation or the compensation of other employees or applicants, or membership or activity in a local human rights commission, or any other category as defined by law.