Patient Access & Revenue Specialist

Description

The Patient Access & Revenue Specialist plays a critical role in ensuring patients experience seamless, timely, and compassionate care across Home Medical Equipment (HME) services by applying respiratory clinical expertise to support patient access, documentation accuracy, and reimbursement readiness. Serving as a cross‑functional connector between RT clinical teams, the intake team, authorization, billing, and customer service, this role identifies and resolves barriers to care, prevents avoidable delays and denials, and ensures payor compliance to support timely start‑of‑care and accurate reimbursement.

This role also provides day‑to‑day supervision and support of the intake team to ensure consistency, accountability, and workflow excellence; while remaining a non‑field, office‑based position focused on access and revenue cycle performance.

• Health, dental, vision insurance + ancillary choices as well
• Teladoc services (provided at no cost)
• $50,000 Life insurance (provided at no cost)
• Employee Assistance Program (provided at no cost)
• 401K retirement + company match
• Short- & long‑term disability
• 15 days paid vacation
• 8 Paid Holidays
• 40 paid volunteer hours
• Bereavement time off
• Quarterly company events

• Facilitate new patient onboarding in collaboration with intake and RT clinical teams.
• Provide functional supervision and support to the intake team, including workflow oversight, prioritization, and problem escalation.
• Ensure intake processes align with payor requirements, documentation standards, and start‑of‑care timelines.
• Ensure timely insurance eligibility verification and benefit coverage for HME services.
• Submit prior authorizations, manage renewals, and support appeal documentation for HME therapies.
• Apply RT clinical knowledge to review documentation (testing results, physician notes, orders) to ensure medical necessity and payor compliance prior to submission.
• Support peer‑to‑peer preparation by providing clinical documentation context and rationale.
• Partner with RT field teams to identify and close documentation gaps that delay start‑of‑care.
• Communicate clearly and empathetically with patients regarding insurance requirements, authorizations, and financial responsibility.
• Collaborate with billing and reimbursement teams to prevent and resolve HME‑related denials.
• Monitor claims status and partner with collectors to support timely payment.
• Identify and elevate recurring payor, documentation, or system issues impacting cash flow or patient access.
• Track and monitor pending authorizations, start‑of‑care delays, and documentation deficiencies.
• Serve as a liaison between RTs, revenue cycle, intake, and customer service teams.
• Recommend process improvements to reduce errors, rework, delays, or denials.
• Assist with training or onboarding related to HME documentation, authorization workflows, or payor requirements.
• Investigate and resolve patient, provider, or payor concerns related to access or billing.
• Deliver high‑touch service and compassionate communication throughout the patient journey.

• Active Respiratory Therapist (RT or RRT) license required.
• 2+ years of experience in healthcare revenue cycle, prior authorization, billing, intake, or related roles.
• Experience in Home Medical Equipment (HME), DME, or home respiratory services are strongly preferred.
• Prior supervisory or team lead experience preferred.
• Strong understanding of insurance benefits, payor requirements, and claims workflows related to HME.
• Knowledge of oxygen, PAP, and ventilator documentation and medical necessity standards.
• Experience working within EHR and revenue cycle systems.
• Detail‑oriented with strong communication, problem‑solving, and follow‑through skills.
• Demonstrated ability to collaborate across clinical and operational teams.
• Ability to manage multiple priorities and meet deadlines in a fast‑paced environment.