Patient Access Coordinator

The Patient Access Coordinator works in close coordination with Patient Access leadership and other clinical and operational stakeholders to complete assigned tasks including denial management, financial clearance of complex visit types, and resolution of escalated high-risk issues. Supports performance improvement efforts by conducting root-cause analysis of data (including denial and patient data), summarizing analyses of identified trends, and supporting meetings with operational stakeholders to drive issue resolution. This position is a liaison between Primary Care Physicians (PCPs), patients, internal providers, Managed Care, and other revenue cycle team members to support Patient Accesses needs and goals. Responsible for working with Patient Access and other departments to develop and maintain training and guidelines around specific patient areas such as: RAVE (Referrals, Authorization, Verification and Eligibility), Financial Counseling, Scheduling, Registration, Admissions, Referrals, Check-in, or Patient Family Access Center. This position requires strong partnering with management and staff across multiple areas but is not limited to Patient Access, Ambulatory Services, Case Management, Patient Financial Services and HIM.

Additional Information
Department Name: Insurance Verification
Job Status: Full time, 40 hours per week
Shift: Day, 8am to 4:30pm, Hybrid

Duties & Responsibilities

• Participates in Patient Access projects, conducting in-depth research and proposing solutions for root cause issues impacting patient accounts, insurance verification, and authorizations. Independently works through complex issues with key stakeholders.
• Ensures adherence to all relevant healthcare compliance and regulatory requirements in daily tasks and projects.
• Maintains high performance standards, actively participate in self-development opportunities, and contributes to team and department goals.
• Coaches and assists team members with challenging accounts. Supports supervisor with ad hoc tasks like analysis, training, and meeting prep.
• Partners with key stakeholders to address patient populations and trends, ensuring follow-up on action items from meetings.
• Identifies high-level trends through data analysis, conducts specialized account research to understand root causes, and proposes/implements solutions. Identifies and implements workflow improvements in Patient Access and other departments.
• Leads recurring meetings discussing metric trends, presents research findings, and proposes actionable solutions with relevant departments. Tracks progress on solutions to ensure prevention measures.
• Resolves assigned accounts (denials, appeals, retro-authorizations) by gathering information, researching contract terms, and ensuring timely appeal submissions. Collaborates with departments and stakeholders to obtain necessary support.
• Develops and delivers training materials for denial management best practices, supporting teams in effective denial management. Works with Patient Access Training team and management to develop documentation and guidelines for denial management.
• Assists users with denial management software, updates and maintains trending reports, and analyzes metrics to identify impactful denial trends.
• Works with systems to identify payment, billing, and collection issues, communicating them to relevant departments within Patient Access and others.

Minimum Qualifications

• Degrees
  • High School diploma or GED
• Area of Study
  • Not Applicable
• Experience
  • Minimum Experience Required:Four (4) years of experience in revenue cycle, claim mitigation and account research, or patient access.
• Equivalency
  • Additional education may substitute for additional experience above required level.
• Licenses & Certifications
  • None
• Additional Requirements
  • Not Applicable
• Competency
  • None

Salary Information
Pay is dependent on applicant's relevant experience.

Hourly Range: $22.20 to $33.30

Benefits Information
Here, you matter. As a Children's Hospital Colorado team member, you will receive a competitive pay and benefits package designed to take care of your needs that includes base pay, incentives, paid time off, medical/dental/vision insurance, company provided life and disability insurance, paid parental leave, 403b employer match (retirement savings), a robust wellness program, and access to professional development tools, including an education benefit to help you advance your career.

As part of our Total Rewards package, Children's Colorado offers an annual employee bonus program that rewards eligible team members based on organizational performance. If organizational goals are met for the year, the bonus is paid out the following April.

Children's Colorado delivers annual base pay increases to eligible team members based on their performance over the previous year.

EEO Statement
It is our intention that all qualified applicants be given equal opportunity and that selection decisions be based on job-related factors. We do not discriminate on the basis of race, color, religion, national origin, sex, age, disability, or any other status protected by law or regulation. Be aware that none of the questions are intended to imply illegal preferences or discrimination based on non-job-related information. The position is expected to stay open until the posted close date. Please submit your application as soon as possible as the posting is subject to close at any time once a sufficient pool of qualified applicants is obtained.

Colorado Residents: In any materials you submit, you may redact or remove age-identifying information such as age, date of birth, or dates of attendance at or graduation from an educational institution. You will not be penalized for redacting or removing this information.