Remote Patient Access & Insurance Verification Specialist

Transformations Care Network; United States; Remote; USD 28,000 - 30,000; Full time

Benefits offered by this job

Medical insurance

Dental coverage

Vision coverage

Low-cost virtual care

Dependent coverage

Domestic partner coverage

401K plan

Job summary

Transformations Care Network is hiring a Patient Access Specialist to join the corporate business support team. This remote role conducts insurance verification, collects copays and balances, and supports multiple departments to keep operations efficient.

You will collaborate with payers and care teams, process batch eligibility, obtain authorizations, and ensure accurate PM/EHR data. Strong communication and attention to detail are essential in a fast-paced, remote US environment.

Qualifications

• Minimum 1 year of physician front office or RCM experience.
• High school diploma.
• Self-starter; able to move own workflow along with minimal oversight.
• Accurate; detail oriented and able to meet tight turnaround times.
• Strong written, verbal, and interpersonal communication skills.
• Ability to exercise initiative, judgment and decision making skills.
• Intermediate computer skills and proficiency in MS Word, Excel Outlook and database management and internet usage
• 2-4 years of physician RCM experience with an emphasis on centralized insurance verification and/or patient access (preferred)
• Ability to have financial discussions with patients (Preferred)

Responsibilities

• Provides cross functional support to Operations, Front Office, Central Intake, and RCM using technologies available.
• Daily processing of a Batch Eligibility Report for all sites and appointment types; demand eligibility for add on appointments and secondary payers utilizing multiple platforms and technologies.
• Identify eligibility exceptions and resolve the rejection (inactive coverage, demographics, coordination of benefits, etc)
• Obtain new insurance information as needed and enter it accurately into the PM/EHR system.
• Verify any new coverage benefits and provide appropriate notifications to cross functional teams if any changes in healthcare coverage could impact care; increased patient liability, need for scheduling with a certain provider, transfer of care
• Identify trends in exceptions on the Batch Eligibility Report and open support cases as needed with appropriate vendors, payers, etc.
• Obtain authorizations and reference numbers as required based on the insurance plan presented and the services scheduled.
• Confirm there is a credit card on file for patients with a financial responsibility and contacts them to obtain the information when none is on file
• Processes the appropriate credit card payments for same day appointments and previous balances
• Initiates the financial hardship workflow when necessary and escalates any patient financial issues to the PFS team as needed.
• Demonstrates a thorough knowledge of mental health insurance guidelines and proficiently verifies reads, and understands benefits and communicates financial responsibility to the patients.
• Maintain knowledge of RCM department policies and procedures
• Develop and maintain positive working relationships with cross-functional teams, teammates and Payor representatives and other key stakeholders
• Consistently meet or exceed the department productivity and quality standards and performance requirements
• Collaborate as needed to identify and resolve underpayments and overpayments
• Other duties and responsibilities as assigned including but not limited to:
• Work overtime with little or no notice as needed
• Attend team meetings, phone conferences, and training as needed

Skills

Communication skills

Detail oriented

Time management

MS Office

Education

High school diploma

Tools

PM/EHR system

Job description

Transformations Care Network is hiring a Patient Access Specialist to join the corporate business support team. This remote role conducts insurance verification, collects copays and balances, and supports multiple departments to keep operations efficient.

You will collaborate with payers and care teams, process batch eligibility, obtain authorizations, and ensure accurate PM/EHR data. Strong communication and attention to detail are essential in a fast-paced, remote US environment.