Insurance Access & Authorization Specialist

Essentia Health; Duluth (MN); Hybrid; USD 42,000 - 54,000; Full time

Job summary

Essentia Health is looking for an Access Coordinator who translates patient information into the system to ensure accurate claim submissions. The role requires coordinating insurance verification, authorizations, and medical documentation with clinicians and patients, while ensuring timely processing in the EMR.

The position emphasizes accuracy in insurance processes, collaboration with care teams, and proactive handling of authorizations and pre-service activities to support reimbursement and

Qualifications

• 1 year of relatable healthcare experience.

Responsibilities

• Prepares and submits payer-specific prior authorizations and referrals in alignment with guidelines and medical policy.
• Identifies required insurance verification and medical documentation per payer policy.
• Collaborates with clinicians to obtain necessary information for authorization approval.
• Documents all interactions and actions related to insurance processes in the EMR system.
• Monitors work queues, focusing on accounts with high reimbursement risk.
• Adapts to urgent clinical needs while maintaining quality within timelines.
• Communicates with patients to facilitate medical clearance.
• Develops pre-service estimates and supports pre-service collections.
• Reviews prior authorization requests that do not meet criteria and coordinates interventions with stakeholders.

Job description

Essentia Health is looking for an Access Coordinator who translates patient information into the system to ensure accurate claim submissions. The role requires coordinating insurance verification, authorizations, and medical documentation with clinicians and patients, while ensuring timely processing in the EMR.

The position emphasizes accuracy in insurance processes, collaboration with care teams, and proactive handling of authorizations and pre-service activities to support reimbursement and