Access Coordinator

Essentia Health; Fargo (ND); Hybrid; USD 24,000 - 36,000; Full time

Benefits offered by this job

Medical Insurance

401(k) with employer contributions

Tuition reimbursement

Job summary

Essentia Health is seeking an Access Coordinator in Fargo, ND to gather insurance details and translate patient information into the EMR for accurate claim submissions.

The role requires 1 year of healthcare experience. Remote/hybrid option available; collaboration with clinicians is essential to obtain all necessary information for authorization approvals.

Qualifications

• 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.
• 1 year of relatable healthcare experience

Responsibilities

• Prepares and submits payer-specific prior authorizations and referrals in alignment with guidelines and medical policy criteria.
• Identifies required insurance verification and medical documentation per payer policy.
• Collaborates with clinicians to obtain information for authorization approval.
• Documents all interactions and actions in the EMR system.
• Monitors work queues and prioritizes high reimbursement risk accounts.
• Communicates with patients to facilitate medical clearance.
• Develops pre-service estimates and supports pre-service collections.
• Reviews prior authorization requests and coordinates clinician-to-health plan interventions when needed.

Skills

Healthcare experience

Job description

Department

1007190 PRE-SERVICE AUTHORIZATION - EH SS

Building Location

Fargo Distribution Serv Center

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

• 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

• 1 year of relatable healthcare experience

Preferred Qualifications

• Healthcare experience within patient care, registration, scheduling, pre-certifications/prior authorizations, collections, and medical terminology

Licensure/Certification Qualifications

1

Possible Remote/Hybrid Option

Remote

Call Obligation

No

Holidays

No

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 [phone].