Patient Access & Referral Navigator

Aultman Hospital; Canton (OH); On-site; USD 36,000 - 48,000; Full time

Job summary

Aultman Hospital is seeking a Patient Access Specialist to serve as a liaison between provider practices and patients for scheduling, prior authorizations, and referrals. You will ensure accurate insurance verification, review coverage rules, and manage authorizations to facilitate timely access to diagnostic tests and specialty care.

In this role you will coordinate referrals, document necessary information, and communicate with patients, physicians, and staff to resolve issues and minimize

Qualifications

• Minimum of one (1) year of physician office experience.
• Knowledge of medical terminology.
• Knowledge of ICD-10 and CPT codes for the purpose of authorizations.
• Knowledge of insurance plans and their rules.

Responsibilities

• Coordinate and process all patient referrals for diagnostic testing and specialty services.
• Verify insurance eligibility and benefits; update patient information as needed.
• Identify referral and authorization requirements from insurance plans and use online resources.
• Prepare and submit documentation to support medical necessity for authorizations.
• Enter referral authorizations into the system and track reports and follow-ups.

Skills

Customer service

Communication skills

Medical terminology

ICD-10 CPT knowledge

Insurance knowledge

Job description

Aultman Hospital is seeking a Patient Access Specialist to serve as a liaison between provider practices and patients for scheduling, prior authorizations, and referrals. You will ensure accurate insurance verification, review coverage rules, and manage authorizations to facilitate timely access to diagnostic tests and specialty care.

In this role you will coordinate referrals, document necessary information, and communicate with patients, physicians, and staff to resolve issues and minimize