Patient Access Specialist

Socket.dev; New Providence (NJ); Hybrid; USD 42,000 - 54,000; Full time

Benefits offered by this job

Medical, dental, and vision package

401(k) plan with company match

Generous PTO and holidays

Life insurance

Job summary

PromptCare is seeking a Patient Access Specialist to manage the timely creation, submission, and follow-up of initial authorization requests to payers. The role involves collaborating with intake, clinical, and billing teams to gather required documentation and ensuring compliance with payer guidelines.

The position is full-time, hybrid (2 days in office, 3 days remote), and reports to the departmental supervisor or manager.

Qualifications

• High School Diploma or equivalent required.
• Experience in healthcare, respiratory or DME preferred.
• Strong knowledge of insurance authorization processes.
• Medical reimbursement background preferred.
• Proficient in Microsoft Office and healthcare systems like Brightree.

Responsibilities

• Collaborate with intake, clinical, and billing teams to gather required documentation.
• Maintain accurate records in Brightree and internal systems.
• Prepare, submit, and track authorization requests to payers promptly.
• Monitor statuses and proactively follow up to prevent delays in patient care.
• Ensure compliance with payer guidelines and company policies.
• Maintain regular contact with patients, insurance plans, physician offices, and respiratory therapists.

Skills

Communication skills

Problem-solving

Attention to detail

Multi-tasking

Healthcare experience

Insurance authorization

Brightree knowledge

Microsoft Office

Education

High School Diploma or equivalent

Tools

Brightree

MS Office

Job description

Description

PromptCare is seeking a highly motivated and detail-oriented Patient Access Specialist?who will possess experience within the healthcare industry, with a particular focus on respiratory therapy, and demonstrate the ability to thrive in a fast-paced environment. This role is primarily responsible for the timely creation, submission, and follow-up of initial authorization requests to assigned payers, ensuring patients receive necessary services without delay.

Reports to: Departmental Supervisor or Manager

Job Type: This is a full-time position, 40 hours per week, Mon-Fri 8:30am-5pm

Job Location: Hybrid (2 days in the office and 3 days working from home)

Requirements

• High School Diploma or equivalent
• Ability to manage multiple tasks and meet deadlines in a fast-paced environment
• Previous experience in healthcare, preferably in respiratory or durable medical equipment (DME)
• Strong knowledge of insurance authorization processes
• Ensure compliance with payer guidelines and company policies
• Medical Reimbursement background is preferred
• Appropriate computer skills for the position (Microsoft Office Suite) and areas of influence
• Experience with Brightree or similar healthcare management systems required
• Strong communication and problem-solving skills
• Clinical, medical office administrative, or related experience preferred

Job Responsibilities, included but not limited to:

• Collaborate with intake, clinical, and billing teams to gather required documentation
• Maintain accurate and up-to-date records in Brightree and other internal systems
• Prepare, submit, and track authorization requests to insurance payers in a timely and accurate manner
• Monitor authorization statuses and proactively follow up to prevent delays in patient care
• Ensure compliance with payer guidelines and company policies
• Regular contact with patients, insurance plans, physician offices, respiratory therapists and other personnel is necessary to ensure timely turnaround and approval
• Escalate problem accounts and ensure resolution
• Understand payer requirements to ensure authorization approval is granted
• Other duties as assigned

Physical Demands

The physical requirements listed here indicate what an employee must meet to effectively perform this role's essential functions. The employee frequently needs to communicate verbally, listen attentively, and spend prolonged periods sitting at a desk and working on a computer. The role also requires lifting files, opening filing cabinets, and bending or standing as needed.

Benefits & Perks:

• Comprehensive Medical, Dental, and Vision Package
• 401(k) Plan with Company Match
• Generous PTO: Vacation, Sick Time, Personal Days, and Paid Holidays
• Life Insurance: Standard coverage with optional enhancements
• Employee Assistance Program: Free counseling and coaching sessions
• Emotional Well-being and Work-Life Balance Resources
• Short & Long-Term Disability: Company-paid with optional supplements
• Accidental Death and Dismemberment Insurance
• FSA and HSA: Manage healthcare expenses
• Commuter Spending Programs
• Employee Referral Bonuses
• Volunteer and Engagement Opportunities
• Exclusive Discounts on entertainment, travel and various other supplemental and cellphone plans

Equal Employment Opportunity?

The PromptCare Companies is committed to Equal Employment Opportunity (EEO) and prohibits employment discrimination on the basis of race, color, age, national origin, religion, gender, gender identity, sexual orientation, pregnancy, marital status, genetic disposition, disability, veteran's status or any other characteristic or classification protected by State/Federal/Local laws. We foster a work environment in which diversity and inclusion are embraced, people are hired and advanced on their merits, and employees are treated with mutual respect and dignity.