Access Manager / Remote
Our Company
Amerita
Overview
The Access Manager monitors all activities and information related to the processing of new referrals and ongoing coordination of patient customer service. This position completes all personnel related tasks for Intake employees and works closely with all branch personnel, referral sources and Revenue Cycle Management department personnel.
Shift: Monday-Friday 8:00am-5:00pm (EST)
Responsibilities
- Leads and manage one of the regional teams responsible for benefit investigation, prior authorization and intake coordination
- Ensures that all intake forms are complete, clear and within Amerita’s scope of service
- Understands which insurance companies Amerita has active contracts with
- Ensures intake personnel are properly performing all functions related to verifying insurance, obtaining authorizations and re-authorizations, registering patients, communicating with other departments regarding referrals, participating in patient care coordination and communicating with patients regarding coverage and financial obligations
- Ensures that processes are followed to ensure insurance verification is completed and authorization is in place prior to giving the referral to the branch
- Responsible for keeping staff current with payer requirements and Amerita policy and procedures related to the intake process, CPR+ functions and managing unbilled revenue
- Understands and adheres to all applicable company policies and state and federal regulations and ensures Intake staff adherence
- Identifies inefficient processes and monitors workload of staff, making recommendations
- Serves as a subject matter expert in local and regional payor requirements, ensuring team alignment with policy changes and payer nuances
- Acts as an escalation point for complex or high impact patients requiring advanced payer knowledge or cross-functional coordination
- Responsible for ensuring applicable ready to bill holds are resolved timely and performs a root cause analysis on holds when necessary
- Participates in and coordinates training for all new intake staff
- Supervisory Responsibility: Yes
Qualifications
- High School Diploma/GED or equivalent required; Associate’s degree or some college preferred
- A minimum of 3 years experience collection referral information in the healthcare market (to include 2 years of supervisory experience)
- Experience working with all payer types to include Medicare, Medicaid and commercial insurance companies
- Home infusion experience a plus
- Knowledge of insurance verification and pre-certification procedures
- Solid Microsoft Office Suite skills
- Strong verbal and written communication skills
- Ability to independently obtain and interpret information
- Knowledge of CPR+ software a plus
- Working knowledge of medical terminology
- Percentage of Travel: 0-25%
To perform this role will require frequently sitting, standing, walking, and typing on a keyboard with fingers, and occassionally bending, reaching climbing (stairs/ladders). The physical requirements will be the ability to push/pull 1-10lbs and lift/carry 21-30 lbs