Patient Access Specialist | Patient Access

Overview

Position Summary:

The Patient Access Specialist is responsible for appointment scheduling for procedures, advanced imaging, and other services as directed. Ensuring the complete and accurate patient demographics, insurance plan details, and benefits information are obtained. The role ensures treatment authorizations are secured in advance while providing excellent customer service to patients.

• Appointment scheduling for all services lines
• Gather complete and accurate patient demographic and financial information.
• Verify and identify insurance plans, obtaining benefit information.
• Interact with patients and insurance companies by phone and confirm patient arrival times for appointments.
• Review insurance eligibility information and accurately note co-pay and deductible details on patient accounts.
• Verify that procedure and diagnosis codes match the ordered tests.
• Confirm all authorizations by contacting insurance companies or using online tools.
• Read and interpret completed physician orders (written or electronic) for proper handling.
• Screen for LMRPs and identify when an ABN is required; explain the ABN/LMRP process in detail to patients and obtain signatures when needed, or gather new orders from physicians to meet medical necessity.
• Complete Medicare Secondary Payer (MSP) Questionnaires for all Medicare patients.
• Operate all essential departmental equipment, maintain adequate supplies at the desk, and keep the work area neat and organized.

Maintain at‑day window: ensure all patients with scheduled appointments are registered, insurance verified, pre‑certified, and fully prepared for their visit.

Qualifications

Education / Training:

• High School Diploma or equivalent

Experience Requirements:

• 0–1 year of experience in a medical office, insurance, or billing/registration – Required
• Preferred: 1 year of experience in medical customer service or registration
• Knowledge of medical terminology and medical insurance terminology, with emphasis on referrals and pre‑certification