Pre-Access Specialist II

Phoenix Children's Hospital, Inc.; Phoenix (AZ); On-site; USD 40,000 - 56,000; Full time

Job summary

Phoenix Children's Hospital, Inc. is seeking a Pre Access Specialist II to ensure accurate insurance verification, authorization and pre-registration for scheduled visits. You will use EMR tools and payer websites to complete documentation and support patients and clinical staff.

The role involves processing verifications, obtaining authorizations, managing daily workload, and maintaining patient relationships while upholding hospital values.

Qualifications

• Associates in Business or related field or equivalent mix of education and experience.
• Experience with EMR, document management/imaging system, or payer websites.
• 1 year authorizations experience for professional/clinic or hospital services.
• Experience discussing out-of-pocket liability with patients/guarantors.
• 1 year of customer service experience.
• Knowledge of CPT, J codes and ICD codes.

Responsibilities

• Verify insurance benefits using automated tools, payer sites, or by phone; estimate out-of-pocket costs.
• Obtain necessary authorizations for services and document details in records.
• Organize and prioritize daily workload to complete tasks.
• Answer calls/emails professionally; support patients, families, and staff to maintain positive relations.
• Participate in hospital education programs to maintain skills and competency.
• Perform miscellaneous duties as assigned.

Skills

EMR proficiency

Payer websites

Authorizations

Customer service

Medical billing codes

Scheduling/registration

Education

Associates in Business or related field

Tools

EMR

Document management/imaging system

Payer websites platform

Job description

Location: Phoenix

Shift: Mon-Fri, Days, 8am-5pm

Posting #: 1067799

Employee Type: PRN

Position Summary

The Pre Access Specialist II is responsible for accurate and complete insurance verification, authorization, and complete pre-registration of all scheduled Diagnostic, Surgical, Audiology and/or Rehabilitation visits. The position works within the EMR using an automated insurance verification tool along with payer websites and documents within the EMR.

Position Duties

• Obtains insurance verification and benefits using an automated verification tool, insurance carrier websites, or by phone. Prepares an estimate for scheduled service and notifies the patient/guarantor of any applicable out of pocket and requests payment if applicable. Accurately documents all information in the appropriate fields and or/account notes.
• Obtains all necessary authorizations for Diagnostic, Surgical, Audiology and/or Rehabilitation visits and accurately documents all information in the appropriate fields and/or account notes.
• Organizes, prioritizes and reviews daily work activity to ensure completion of assigned workload.
• Courteously answers telephone and/or emails and answers all questions in a timely manner. Maintains a positive working relationship with patients/guarantors, insurance companies, clinical personnel, co workers, and management to promote teamwork, cooperation, and a positive public image for Phoenix Children's.
• Participates in a variety of unit and hospital educational programs to maintain current skill and competency levels.
• Performs miscellaneous job related duties as requested.

Phoenix Children's Mission, Vision, & Values

Mission

To advance hope, healing and the best healthcare for children and their families

Vision

Phoenix Children’s will be the leading pediatric health system in the Southwest, nationally recognized for exceptional care, innovative research and advanced medical education.

We realize this vision by:

• Offering the most comprehensive care across ages, communities and specialties
• Investing in innovative research, including emerging treatments, tools and technologies
• Advancing education and training to shape the next generation of clinical leaders
• Advocating for the health and well-being of children and families

Values

• We place children and families at the center of all we do
• We deliver exceptional care, every day and in every way
• We collaborate with colleagues, partners and communities to amplify our impact
• We set the standards of pediatric healthcare today, and innovate for the future
• We are accountable for making the highest quality care accessible and affordable

Position Qualifications

Please review the following qualifications and specify whether you meet each of the requirements listed.

Education

Do you meet this requirement or have the ability to obtain it within the timeframe listed in the requirement?

• 1. Associates in Business or related field OR an equivalent combination of education and experience. Required

Experience

Do you meet this requirement or have the ability to obtain it within the timeframe listed in the requirement?

• 1. Experience with EMR, document management/imaging system, or Payer websites platform. Required
• 2. One (1) year of experience requesting Professional/Clinic or Hospital Authorizations. Required
• 3. Experience reviewing and discussing out of pocket liability to patients/guarantors. Required
• 4. One (1) year of customer service experience. Required
• 5. Knowledge base and experience with CPT codes, J Codes, and ICD Codes. Required
• 6. One (1) year of medical registration or scheduling experience. Preferred

Special Skills

Do you meet this requirement or have the ability to obtain it within the timeframe listed in the requirement?

• 1. Must be able to work independently and effectively in a high-volume, fast paced environment with changing priorities. Must possess customer-focused attitude and professional demeanor. Required
• 2. Excellent communication skills (Written and Oral). Required
• 3. Knowledge of Medical Terminology and an understanding of HIPAA Privacy Laws. Required
• 4. Analytical skills with strong attention to detail and a high degree of accuracy. Required
• 5. Proficiency with computer based systems. Required
• 6. Bilingual (Spanish). Preferred
• 7. Follow any payer or governmental requirement as required by the organization. Required

Physical Requirements & Occupational Exposure/Risk Potential

1. Physical Requirement - Climbing - Occasionally

2. Physical Requirement - Feeling (sensing textures and temperatures) - Occasionally

3. Physical Requirement - Fine Motor Skills (pinching, gripping, etc) - Frequently

4. Physical Requirement - Hearing - Frequently

5. Physical Requirement - Pushing/pulling - Occasionally

6. Physical Requirement - Reaching - Occasionally

7. Physical Requirement - Sitting - Constantly

8. Physical Requirement - Standing - Occasionally

9. Physical Requirement - Stooping/crouching/kneeling/crawling - Occasionally

10. Physical Requirement - Talking - Constantly

11. Physical Requirement - Tasting/smelling - Occasionally

12. Physical Requirement - Walking - Occasionally

13. Physical Requirement - Near Vision - Frequently

14. Physical Requirement - Far Vision - Frequently

15. Physical Requirement - Color Discrimination - Occasionally

16. Physical Requirement - Use of keyboard, mouse and/or computer equipment - Constantly

17. Physical Requirement - Lift up to 35 pounds without assistance - Occasionally

18. Physical Requirement - Lift more than 35 pounds without assistance - Occasionally

I have reviewed the qualifications, physical requirementsand occupational exposure/risk potential for this position and wish to apply I Agree