Position Summary
Under the direction and guidance of the Associate Director of Patient Access and Regional Manager of Patient Access, the Patient Access Insurance Coordinator completes one or more of the following processes (scheduling, pre-registration, financial clearance, authorization and referral validation and pre-serviceability estimations and collections).

Duties and Responsibilities

• Adhere to and uphold all applicable federal and state compliance regulations, the NSPC Code of Conduct, the
• NSPC Employee Handbook, compliance policies and procedures, and applicable healthcare fraud, waste and abuse laws.
• Articulates information in a manner that patients, guarantors and family members understand so they know what to expect and understand their financial responsibilities.
• Conducts scheduling and preregistration functions, validates patient demographic data, identifies and verifies medical benefits, accurate plan code and COB order.
• Obtains limited clinical data based on service required.
• Corrects and updates all necessary data to assure timely, accurate bill submission.
• Verifies insurance information through payor contacts via telephone, online resources, or electronic verification system.
• Identifies payor authorization/referral requirements.
• Provides appropriate documentation and follow up to physician offices, case management department, and
• payors regarding authorization/referral deficiencies.
• Cooperates with and maintains excellent working relationships with patients, NSPC leadership, providers, staff and designated external agencies or vendors.
• Performs any written or verbal communication necessary to exchange information with designated contacts and promote working relationships.
• Adheres to NSPC organizational policies and procedures for relevant location and job scope.
• Completes and/or attends mandatory training and education sessions within approved organizational guidelines and timeframes.
• Performs other duties as assigned or required.

Qualifications and Skills

• High School Degree/GED required.
• Three (3) years of experience with insurance verification, authorization, and medical billing.
• Patient Accounting, 3rd Party Payor and/or Managed Care experience.
• Possess thorough knowledge of HIPAA regulations.
• Excellent organizational/multi-tasking skills with acute attention to details.
• Experience with Electronic Medical Records (EMR) systems, required.
• Experience in Pain Management, Regenerative Medicine, or Orthopedics strongly preferred.
• High level of interpersonal skills to handle sensitive and confidential situations and documentation.
• Ability to interact positively and effectively with multi-disciplinary teams and across all National Spine and Pain regions.

Physical Requirements

• Extensive and regular periods of sitting, standing, bending, walking, seeing, talking, and listening.
• A full range of body motion including complete manual and finger dexterity, as well as effective hand-eye
• coordination.
• Adequate visual acuity including ability to read information.
• An occasional requirement to reach with hands/arms, stoop, kneel, or crouch