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About the Role

The Patient Access Insurance Coordinator supports the strategic vision and goals of Shriners Hospitals for Children by determining insurance eligibility and coverage. This role involves contacting payors, resolving patient access edits, and maintaining knowledge of various payor guidelines.

Responsibilities

• Performs insurance verification functions for assigned SHC facilities.
• Updates encounters in SHCIS with the appropriate eligibility and COB status.
• Documents all insurance verification actions in the health plan comment field on the encounter.
• Updates health plan as needed based on feedback from the insurance company.
• Maintains knowledge of payors’ authorization/referral guidelines and updates SHCIS.
• Maintains a daily productivity log for insurance verification.
• Performs bill hold review for assigned facilities.
• Reviews bill hold worklists in the bill scrubber and updates SHCIS to resolve bill holds.
• Documents actions taken to resolve bill holds in the health plan comment fields.
• Documents actions taken to resolve bill holds in the bill scrubber and assigns back to the CBO.
• Maintains a daily productivity log for bill hold resolution.
• Plans and organizes work to meet department and corporate goals.
• Coordinates and prioritizes assigned activities for maximum productivity.
• Makes recommendations for quality and efficiency improvements to the Corporate Manager of Patient Access.
• Identifies system issues, assists in root cause analysis, and submits recommendations for resolution.
• Completes special projects as directed by the Corporate Manager of Patient Access.
• Demonstrates a positive and professional image when interacting with others.
• Responds positively to necessary changes in the workplace.
• Assumes responsibility for professional growth and development.
• Attends workshops and seminars to maintain knowledge of payor criteria.
• Maintains professional competency according to department policies and procedures.

Requirements

• 3 years of insurance verification and authorization experience
• 3 years of medical billing and utilization experience
• Strong Epic registration and scheduling experience
• Competency in MS Office
• High School Diploma / GED

Skills

• Insurance verification
• Authorization
• Medical billing
• Utilization review
• Epic registration
• Epic scheduling
• MS Office

Location

• Remote

Work Type

• Full-time

Experience Level

• 3 years

Education Level

• High School Diploma / GED

Salary/Compensations

• $21.96 - $32.94

About the Company

• Shriners Children’s is an organization that respects, supports, and values each other.
• Named as the 2025 best mid-sized employer by Forbes.
• Engaged in providing excellence in patient care, embracing multi-disciplinary education, and research with global impact.
• Fosters a learning environment that values evidenced based practice, experience, innovation, and critical thinking.
• Compassion, integrity, accountability, and resilience define them as leaders in pediatric specialty care.
• With 20+ hospitals, outpatient clinics, ambulatory care centers and outreach locations across the globe, they provide excellent care to children up to age 18 regardless of their family’s ability to pay or insurance status.