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Patient Access Representative II – Insurance Verification Representative

tmcaz.com Logo

Tucson Medical Center

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Location:
United States , Tucson

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Category:
-

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Contract Type:
Not provided

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Salary:

Not provided

Job Description:

The Patient Access Representative II – Insurance Verification is responsible for advanced insurance verification, authorization coordination, and financial clearance functions. This role supports complex cases and serves as a resource for junior staff, ensuring accurate and timely processing of patient access workflows. The Representative II demonstrates a high level of proficiency in payer requirements, EHR systems, and patient communication.

Job Responsibility:

  • 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

Requirements:

  • 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

Nice to have:

CHAA or related certification

Additional Information:

Job Posted:
February 14, 2026

Employment Type:
Parttime
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