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AI Summary

The Patient Access Concierge manages patient registration, insurance verification, appointment scheduling, and prior authorizations independently. They also serve as a bilingual resource for patients and providers while ensuring compliance with HIPAA and organizational policies.

Location: United States | Remote


Location Eligibility: Candidates must currently reside in the United States. This role is not available to residents of California, New Jersey, New York, Montana, Hawaii, or Alaska, or of any U.S. territory.


Summary

The Bilingual Patient Access Concierge independently manages a broad range of patient access activities, including patient registration, insurance verification, appointment scheduling, and prior authorizations, with minimal oversight.


You'll be a knowledgeable resource for patients, providers, clients, and newer team members. You'll resolve more advanced insurance and scheduling issues and help spot ways to improve workflows. This role suits someone who has mastered the fundamentals and is ready to work with more independence, take on more complex cases, and begin informally mentoring others.


Responsibilities

Patient Registration

  • Accurately collect, verify, and maintain patient demographic, insurance, and clinical information.
  • Review patient accounts for completeness and resolve registration discrepancies before scheduled services.
  • Ensure all required documentation is complete and accurately recorded.

Insurance Verification and Prior Authorizations

  • Verify insurance eligibility, benefits, referrals, and authorization requirements across a variety of payer types.
  • Obtain, monitor, and document prior authorizations and referrals while ensuring payer requirements are met.
  • Investigate and resolve complex insurance eligibility, authorization, and coverage issues independently.
  • Communicate authorization requirements, financial responsibility, and coverage concerns to patients, providers, and internal stakeholders.

Bilingual Patient Support

  • Communicate fluently in Spanish and English with patients, families, and providers by phone and in writing.
  • Explain insurance eligibility, prior authorization requirements, financial responsibility, and appointment instructions in Spanish in plain, easy-to-understand terms.
  • Accurately document Spanish-language interactions in English within the EMR and other assigned systems.
  • Recognize when a conversation needs a qualified medical interpreter, such as clinical or consent discussions, and follow established interpreter and language access procedures.
  • Serve as a Spanish-language resource for team members and help identify ways to improve the experience for patients with limited English proficiency.

Scheduling and Customer Service

  • Schedule, reschedule, and coordinate appointments while following client and provider scheduling guidelines.
  • Serve as a point of contact for escalated patient, provider, and client inquiries.
  • Deliver exceptional customer service while resolving complex scheduling and patient access issues.
  • Build collaborative relationships with provider offices, insurance carriers, and internal departments to support timely patient care.

Documentation and Compliance

  • Maintain complete, accurate, and timely documentation within all assigned systems.
  • Ensure compliance with HIPAA, client requirements, payer guidelines, and organizational policies.
  • Identify documentation or workflow issues and take appropriate corrective action.

Operational Excellence

  • Meet and exceed established productivity, quality, attendance, and service expectations, along with all other relevant team metrics.
  • Assist with onboarding and training new team members by sharing knowledge and best practices.
  • Identify workflow inefficiencies and recommend process improvements that enhance operational performance.
  • Adapt to changing payer requirements, client expectations, and operational priorities.
  • Participate in departmental meetings, quality initiatives, and continuous improvement efforts.
  • Perform other duties as assigned.

Qualifications and Experience

  • High school diploma or GED required.
  • Fluency in spoken and written Spanish and English required; a language proficiency assessment is part of the hiring process.
  • One to four years of Patient Access, Medical Scheduling, Registration, or related healthcare experience required.
  • Demonstrated ability to independently verify insurance eligibility, obtain prior authorizations, and manage appointment scheduling.
  • Experience resolving moderately complex insurance, authorization, or patient access issues with minimal guidance.
  • Ability to explain healthcare and insurance terms in Spanish, such as deductible, copay, prior authorization, Medicaid, and Medicare.
  • Working knowledge of commercial insurance, Medicare, Medicaid, and managed care plans.
  • Experience using electronic medical record (EMR) systems such as Epic or Cerner preferred.
  • Familiarity with Spanish medical terminology preferred.
  • Cultural awareness and sensitivity when serving diverse patient populations, including familiarity with regional variations in Spanish.
  • Excellent customer service, communication, organizational, and problem-solving skills.
  • Proficiency with Microsoft Office and web-based healthcare applications.
  • Ability to manage multiple priorities while maintaining a high level of accuracy and professionalism.
  • Ability to work independently in a remote environment with limited day-to-day oversight.

Physical Demands and Working Conditions

  • Fully remote, U.S.-based position.
  • Requires reliable high-speed internet and a private, quiet, and focused workspace that protects patient confidentiality.
  • Prolonged sitting while working at a computer and using a telephone or headset.
  • Clear, professional communication in both Spanish and English with patients, providers, and colleagues in every interaction.
  • High volume of calls and inquiries, including phone-based communication for up to 8 hours per day. A significant portion of calls may be in Spanish.
  • Frequent typing and data entry across multiple software applications.
  • Continuous communication with patients, providers, insurance carriers, clients, and internal team members.
  • Occasional overtime may be required based on business needs.

Benefits

  • FLSA Classification: Non-Exempt
  • Benefits Offered:
    • Employer sponsored Medical, Dental & Vision
    • HSA Employer Contributions, Employer Paid Life, Short-term and Long-term Disability, and AD&D Insurance Plans
    • Flexible Time Off Plan & Paid Holidays
    • Employee Referral Bonus


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