Patient Access Representative at The Dermatology Specialists

New York, New York, United States -

Full Time

Start Date

Immediate

Expiry Date

25 Jun, 26

Salary

70000.0

Posted On

27 Mar, 26

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Eligibility Verification, Insurance Validation, Scheduling Support, Pre-authorizations, Referrals, EMR Systems, Payer Portals, HIPAA Compliance, Data Maintenance, Patient Communication, Revenue Cycle, Time Management, Organizational Skills, Process Improvement

Industry

Hospitals and Health Care

Description

The Patient Access Specialist performs front-end patient access activities to ensure accurate and complete eligibility verification, insurance information, and scheduling support. This role collaborates with the Patient Access Supervisor and other Revenue Cycle teammates to verify coverage, obtain pre-authorizations or referrals as required, update payer information, and communicate any insurance concerns to patients. The Specialist supports timely patient scheduling and contributes to minimizing appointment delays and revenue cycle bottlenecks. Key Responsibilities: · Perform pre-visit eligibility verification and insurance validation for upcoming appointments using payer portals and internal systems. · Confirm current benefits, coverage, network status, and effective dates; identify potential coverage gaps or pre-authorization/referral requirements. · Obtain and document necessary authorizations, referrals, or pre-certifications as required by payer policies and practice guidelines. · Notify patients of potential insurance issues (e.g., uncovered services, out-of-pocket estimates, authorization needs) and coordinate next steps with scheduling and financial counseling. · Update and maintain accurate patient and insurance information across multiple systems (EMR, scheduling, and billing platforms) to ensure correct pre-authorization, billing, and eligibility data. · Communicate clearly with patients regarding verification outcomes, next steps, and any required financial responsibilities. · Collaborate with scheduling, clinical staff, and payors to resolve insurance-related scheduling barriers and ensure timely care. · Escalate complex or unresolved issues to the Patient Access Supervisor with recommended remediation plans. · Maintain compliance with HIPAA and privacy/security requirements in all interactions and data handling. · Document interactions and outcomes in the EMR and relevant systems; maintain accurate, auditable notes. · Participate in process improvement initiatives to streamline intake workflows, improve eligibility capture, and reduce pre-visit denials. Required Qualifications: · High school diploma or equivalent; associate degree or related certifications preferred (e.g., CHAA, CPC, CPAR, or revenue cycle certification). · Experience in patient access, eligibility verification, scheduling support, or front-end Revenue Cycle activities, preferably in dermatology or outpatient settings. · Familiarity with payer enrollment and pre-authorization workflows; ability to interpret basic EOBs and coverage data. · Proficient with EMR systems and payer portals; comfortable navigating multiple systems to extract and update information. · Strong communication skills with the ability to explain insurance concepts clearly to patients. · Knowledge of HIPAA requirements and commitment to patient privacy and data security. · Ability to collaborate effectively with front desk staff, clinicians, and Revenue Cycle colleagues. · Detail-oriented with strong organizational and time-management skills. Preferred Qualifications: · Experience with dermatology or cosmetic dermatology services. · Bilingual abilities (e.g., English/Spanish) to support a diverse patient population. Compensation: $70,000 per year

Responsibilities

This role involves performing front-end patient access activities, including verifying eligibility and insurance information, obtaining necessary authorizations, and supporting timely patient scheduling. The specialist must update patient and insurance data across systems and communicate coverage details and financial responsibilities clearly to patients.