Patient Access Advisor

Romehosp; City of Rome (NY); On-site; USD 48,000 - 64,000; Full time

Job summary

Romehosp is seeking a Patient Access Advisor to verify insurance coverage, validate medical necessity, collect patient payments, and obtain or verify authorizations for procedures, including high-cost drugs.

The role emphasizes accurate data entry, excellent customer service, and meticulous documentation while ensuring compliance with hospital policies and regulatory standards. Prior experience in healthcare is preferred, along with CHAA/CHAM certification if available.

Qualifications

• High School Diploma or GED required.
• Experience in healthcare settings preferred but not required.
• Familiarity with health insurance processes and medical terminology preferred.
• Strong verbal and written communication skills.
• Professional telephone etiquette and client service mindset.

Responsibilities

• Explain required forms and obtain patient signatures.
• Verify insurance coverage and document prior authorizations.
• Validate medical necessity for ordered services.
• Collect patient out-of-pocket payments at the point of service.
• Ensure physician orders are present and compliant with hospital policy.
• Maintain accurate documentation in accordance with regulatory standards.

Skills

Communication

Data entry

Office equipment

Phone etiquette

Attention to detail

Education

High School Diploma or GED

CHAA/CHAM certification

Job description

Patient Access Advisor

The Patient Access Advisor is responsible for completing insurance verification, medical necessity validation, point of services collections, obtaining authorizations or validating authorizations have been secured for procedures including high cost drugs. This role ensures accurate collection and verification of patient information while delivering excellent customer service.

Key Responsibilities

• Explain required forms and obtain patient signatures as appropriate
• Verify insurance coverage and document prior authorizations
• Validate medical necessity for ordered services
• Collect patient out-of-pocket payments
• Ensure physician orders are present and compliant with hospital policy
• Maintain accurate documentation in accordance with regulatory and organizational standards

Experience

• Experience in an acute care hospital, physician's office, or other healthcare setting is preferred, but not required

Knowledge

• Knowledge of office procedures and equipment
• Familiarity with health insurance processes and medical terminology preferred

Skills

• Strong verbal and written communication skills
• Proficient keyboarding and data entry abilities
• Ability to operate standard office equipment
• Professional telephone etiquette
• Strong attention to detail and ability to process detailed information accurately

Education

• High School Diploma or GED required
• CHAA/CHAM certification preferred