What You'll Do:
The Patient Access Specialist facilitates timely access to care by ensuring patient eligibility and that benefits are verified prior to service and updates the information in the Electronic Health Record (EHR) accordingly. In the event a patient does not have insurance, this position assesses and determines if a patient qualifies for Medicaid or Federal Marketplace insurance coverage and assists in the application process. This position works with health plans to obtain coverage for uninsured patients seeking services within Connections Health Solutions (CHS). The PAS reconciles daily visits with requested and confirmed applications and is responsible for correcting any claims denied or rejected for eligibility or benefits as it relates to the appropriate payer associated with the individual’s account.
- Researches and resolves registration and enrollment issues during an individual's stay.
- Complete prior authorizations for scheduled services by coordinating with insurance companies, providers, and clinical staff to obtain timely approvals.
- Ensures the accuracy of patient demographic information, updating as necessary.
- Verify eligibility and benefits for daily visits in accordance with CHS procedures.
- Assists with obtaining missing data to support eligibility determinations.
- Works with CHS staff and health plans to assist patients with completing applications for enrollment with Medicaid plans.
- Collects and communicates necessary information regarding individual’s insurance carrier.
- Tracks Medicaid applications, to ensure completeness and acceptance.
- Update Electronic Health Record (EHR) with pertinent information required for timely and accurate billing.
- Resolve registration and authorization issues during the individual in crisis visit.
- Review eligibility software daily to correct errors identified during the individual's visit.
- Assist individual's with identifying the appropriate Financial Assistance Program that meets their needs.
- Coordinate additional information obtained with clinical operations and RCM teams.
- Perform check-out review to ensure that no additional information is needed before claim submission.
- Performs all other duties as assigned.
What You'll Bring:
- High School diploma or equivalent
- Patient registration in a multi-specialty or Hospital environment
- 2 years of medical billing (eligibility)
- Working knowledge of Medicaid, Medicare, and Commercial products
- State of Virginia Fingerprint Clearance
- Must be able to pass Virginia Department of Behavioral Health & Developmental Services (VA DBHDS) background check
- Must be able to pass Virginia Department of Social Services (VA DSS) Office of Background Investigations - Central Registry Search
- The Company has a mandatory vaccination policy. All successful applicants must be fully vaccinated, including showing proper documentation, or otherwise be exempt pursuant to the Company’s exemption process prior to their start date as a condition of employment
It would be great if you had:
- Bachelor’s degree in Health care or related field
- Bilingual in Spanish
This is a fully remote position in these states: AL, AR, AZ, CA, CO, CT, DC, FL, GA, IL, IN, KS, KY, LA, MD, ME, MI, MN, MT, NC, NJ, NY, OH, OR, PA, SC, TN, TX, VA, WA, WI
What We Offer:
Full-time only:
- Employees (and their families) are offered comprehensive health insurance, including Medical, Dental, Vision, Accident, Critical Illness, and Hospital Indemnity
- CHS pays for Basic Life, AD&D, Short and Long-Term Disability
- Voluntary Life insurance option for employees and their families
- Health Savings Accounts (with $1,000 to $2,000 employer contribution depending on plan)
- Flexible Spending Accounts (health care and dependent care)
- 401k company match after 6 months (50% of deferrals up to 6% of compensation)
- Generous PTO starting at 160 hours accrued annually and 12 recognized company holidays
- Company‑paid parental leave available to eligible employees
All employees (Pool, Part-time and Full-time):
- Employee Assistance Program to help with confidential emotional support, work life solutions, financial solutions, legal assistance, or online support
- After 90 days, you are auto enrolled in the 401k Plan
Connections Health Solutions is proud to be a Second Chance Employer.
#INDVA
Actual compensation is based on relevant experience, education, internal equity, and budget.
EEO Statement
Connections Health Solutions is an equal opportunity employer. We do not discriminate based on race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other characteristic protected by law. We are committed to creating an inclusive and welcoming environment for all employees and applicants.
Recruitment Fraud Warning
Connections Health Solutions has been made aware of individuals impersonating our recruiters and issuing fraudulent interview invitations and job offers.
Please note:
- Official communications come only from an email address ending in @connectionshs.com.
- We will never extend an offer without completing our formal interview process.
- We will never ask candidates to pay fees, purchase equipment, or send money as part of the hiring process.
If you receive a suspicious communication claiming to represent Connections Health Solutions, please contact myRecruiter@connectionshs.com to verify its authenticity before responding.