Patient Access Representative

• Perform insurance verification and authorization functions supporting Patient Access Services
• Complete authorization initiation requests with payers for acute and ambulatory visits
• Validate existing provider-requested authorizations
• Use authorization submission tools, payer websites, documents, and Host systems
• Provide authorization numbers and patient demographic information to billing and other appropriate staff
• Explain referral processes to physicians and staff
• Document and maintain referral and authorization records
• Refer encounters for peer review to substantiate ordered procedures
• Respond to provider orders for tests, procedures, and specialty visits
• Obtain authorizations for single and recurring visits, verifying demographics, codes, service dates, and clinical data
• Stay current on payer requirements and use third-party authorization submission software
• Work independently from a remote location using structured work routines
• Prioritize work and ensure appropriateness and timeliness of patient care
• Escalate accounts that do not meet authorization standards and coordinate resolution with providers, scheduling departments, PAS leaders, and administrative groups
• Perform related duties, including cross-coverage in other authorization-related areas

Patient Access Representative jobs in Colorado

Patient Access Services Authorization Representative