Patient Access Specialist - Full Time, Days

About the role

Jupiter Medical Center, ranked #1 for safety, quality and patient satisfaction in Palm Beach County, is hiring a full-time Patient Access Specialist working days. The specialist delivers a strong customer experience, handles patient registration and insurance verification, and supports accurate coding and claims.

Key responsibilities

• Obtain demographic, insurance and medical information to ensure accurate and complete registration.
• Perform insurance verification, data collection and documentation, and determine medical necessity of services.
• Identify patient financial responsibilities and collect applicable monies.
• Act as liaison between patients and the hospital to facilitate access to services.
• Review documentation to ensure provider coding is supported and accurate, applying CPT and ICD-10 codes and modifiers.
• Assist the manager in educating physicians and staff on documentation requirements for reimbursement.
• Help conduct monthly internal audits of patient charges and documentation.
• Submit claims daily, work rejections, check for data errors, and resubmit or appeal rejected claims.
• Check and post charges, scrub and review charges before claims are submitted, and review surgical claims and post-op visits.
• Run daily insurance exception reports, correct rejected claims, and advise on procedural changes to prevent rejections.
• Adhere to Medicare, Medicaid and managed care plan requirements and perform other duties as assigned.

Required profile

• High school graduate or equivalent.
• BLS certification through the American Heart Association for healthcare providers.
• Experience with EMR systems, insurance verification, eligibility and electronic billing; billing and coding certification preferred.
• Knowledge of health insurance plans and benefits, and of CPT and ICD-10 coding rules, including modifiers for radiation oncology, infusion and oncology surgery.
• Ability to read and follow CMS and NCCN guidelines and to maintain confidentiality.
• Customer support experience, medical terminology knowledge, and proficiency in Microsoft Office.
• Good communication, organizational, and multitasking skills; flexible and service-oriented.

Required skills

• EMR systems
• CPT and ICD-10 coding
• Insurance verification and eligibility
• Microsoft Office