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Company Contact Info

  • 2900 North Rocky Point Drive
    Tampa, FL 33607
  • Susan Parker

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Patient Access Insurance Coordinator

Shriners Hospitals For Children • Tampa, FL

Posted 27 days ago

Job Snapshot

Full-Time
Experience - 3 years
Degree - High School
Healthcare - Health Services
Health Care

Job Competition

49

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Job Description

Under the leadership of the Corporate Patient Access Manager, the Patient Access Insurance Coordinator is an active member of the Patient Financial Services and Patient Access team, which delivers support that is consistent with the strategic vision, goals, philosophy and direction of Shriners Hospitals for Children (SHC). The Patient Access Insurance Coordinator is responsible for determining the status of a patient’s insurance eligibility/coverage by contacting the appropriate insurance or third party payor in accordance with SHC policies and procedures, for assigned facilities.  The Patient Access Insurance Coordinator may also be called upon to assist assigned facilities with resolving their patient access edits in the bill scrubber.  The Patient Access Insurance Coordinator will have a thorough knowledge and understanding of Commercial, Managed Care, Medicaid, Managed Medicaid and Medicare payor guidelines and eligibility criteria. The Patient Access Insurance Coordinator will physically be located at SHC headquarters office, but perform their job functions for assigned facilities that are located throughout the United States.


POSITION RESPONSIBILITIES:

  • Under direction from the Corporate Patient Access Manager, performs insurance verification functions for assigned SHC facilities. (40%)

    • Updates encounters in SHC’s IS system (SHCIS) with the appropriate eligibility and COB status.

    • Documents, in the health plan comment field on the encounter, all actions that have been taken on the account related to insurance verification.

    • Updates health plan as needed based on feedback from the insurance company.

    • Maintains a detailed level of knowledge of all payors’ authorization/referral guidelines and updates all appropriate fields in SHCIS to drive encounters to worklists

    • Maintains a daily productivity log.

  • Under direction from the Corporate Patient Access Manager, performs bill hold review for assigned facilities. (30%)

    • Reviews assigned bill hold worklists in the bill scrubber and updates the SHCIS encounter to resolve the bill hold and release the claim

    • Documents, in the health plan comment fields on the encounter, all actions that have been taken to resolve the bill hold

    • Documents, in the bill scrubber, the action that was taken to resolve the bill hold and assigns back to the CBO

    • Maintains a daily productivity log

  • Plans and organizes the work and activities of area of responsibility to ensure department and corporate goals are met (5%)

    • Coordinates and prioritizes assigned activities to achieve maximum productivity

  • Makes recommendations to the Corporate Manager of Patient Access for quality and efficiency improvements. (10%)

    • Identifies system issues, assists in identifying root causes of issues and submits recommendations to the Corporate Manager of Patient Access and IS department for resolution

  • Performs other related job duties as assigned (5%)

    • Completes special projects as directed by the Corporate Manager of Patient Access.

  • Demonstrates a positive and professional image at all times when interacting with management, staff and others (5%)

    • Responds positively to necessary changes in the workplace

  • Assumes responsibility for professional growth and development (5%)

    • Attends workshops and seminars, reads manuals and updates to maintain a high level of knowledge of all payor criteria

    • Maintains professional competency, according to department policies, procedures and protocols

Job Requirements


The qualified candidate will have experience in the following areas

  • 3 or more years of experience working as an Insurance Verifier in an acute care hospital, physician practice or other healthcare setting; required.

  • Experience working in a children’s hospital helpful.

Minimum Education Required/Preferred:

  • High School Degree or GED required

Knowledge, Skills, and Competencies:

  • Strong analytical and problem solving skills

  • Well-developed communication skills required

  • Exhibits competency in the use of  Microsoft Word, Excel, Word Perfect, PowerPoint, Visio

  • Strong Cerner registration and scheduling knowledge and experience preferred

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