Patient Access Rep II – Insurance Verification Rep

• Verify insurance eligibility and benefits for complex and high-priority cases using payer portals and electronic tools.
• Obtain and document prior authorizations, including peer-to-peer requests and escalations.
• Coordinate with clinical departments and physician offices to ensure accurate procedure and diagnosis coding.
• Provide mentorship and training to Patient Access Representative I staff.
• Assist in resolving escalated patient inquiries and insurance issues.
• Ensure accurate and complete patient registration and financial documentation.
• Collect co-pays, deductibles, and outstanding balances
• establish and monitor payment plans.
• Maintain compliance with HIPAA, organizational policies, and payer regulations.
• Participate in quality improvement initiatives and workflow optimization projects.
• Performs related duties as assigned.

• Two (2) years of experience in a healthcare setting with a focus on insurance verification or patient access.
• Advanced knowledge of insurance plans, medical terminology, and healthcare billing practices.
• Strong communication and customer service skills with the ability to de-escalate complex situations.
• Proficiency in EHR systems, payer verification tools, and Microsoft Office Suite.
• Ability to multitask, prioritize, and manage time effectively in a fast-paced environment.
• Attention to detail and accuracy in data entry and documentation.
• Demonstrated leadership and mentoring capabilities.

CHAA or related certification