PA, Preservices Specialist

Patient Access Pre-Services Specialist

The Patient Access Pre-Services Specialist reflects the mission, vision, and values of Amplify RCM, adheres to the organization's Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines, and all other regulatory and accreditation standards. This position reports to the Patient Access Manager.

The Patient Access Pre-Services Specialist is responsible for ensuring a smooth and efficient pre-registration and pre-authorization process for patients prior to their scheduled medical procedures or appointments. This role involves verifying patient demographics, verifying insurance coverage, verifying necessary authorizations, communicating with patients regarding financial responsibilities, and coordinating with clinical and administrative teams to ensure seamless patient access to care.

Duties and Responsibilities include: Collect and verify patient demographics and insurance details. Ensure accuracy of patient data in the hospital's electronic health record (EHR) system. Verify accuracy physician orders and facility guidelines. Confirm insurance eligibility and benefits before services are rendered. Confirm prior authorizations for procedures, and diagnostic tests, as required by insurance providers. Communicate with insurance companies to resolve coverage issues and prevent delays in care. Notify patients of their financial responsibilities, including co-pays, deductibles, and out-of-pocket costs. Provide information on payment options, financial assistance, and insurance coverage. Address patient non-clinical questions and concerns regarding their upcoming visit. Work closely with clinical staff, billing departments, and insurance representatives to ensure all necessary documentation is completed. Follow up on pending insurance approvals and escalate urgent cases as needed.

Knowledge, Skills, and Abilities include: Strong knowledge of medical terminology, insurance policies, and healthcare billing practices. Excellent communication and customer service skills. Ability to handle confidential patient information with discretion. Proficiency in EHR systems and scheduling software. Detail-oriented with strong organizational and multitasking abilities.

Work Experience, Education, and Certifications include: High school diploma or equivalent required; Associate's degree in healthcare administration or a related field preferred. Experience in patient access, insurance verification, medical billing, or a related healthcare role is highly desirable.

Working Conditions and Physical Requirements: Remote – work from home

Travel Requirements: No travel