Job Title:ย ย ย Patient Access & Eligibility Specialistย
ย ย Overview:ย
The Patient Access & Eligibility Specialist plays a critical role in supporting patient access to care management services by ensuringย accurateย insurance verification, confirming program eligibility, andย assistingย patients through administrative intake processes.ย
This role serves as theย front door to the care management program, helpingย identifyย eligible patients for Chronic Care Management (CCM), Remote Patient Monitoring (RPM), and other virtual care services.ย
The Patient Access & Eligibility Specialist verifies insurance coverage, confirms patient eligibility, answers incoming patient calls, manages voicemail communications, and ensuresย accurateย documentation within electronic medical record (EMR) systems and care management platforms.ย
The ideal candidate has strong technicalย proficiency, excellent communication skills, and the ability to navigate multiple healthcare systems efficiently while deliveringย a professionalย and compassionate patient experience.ย
Reports To:ย Nursing Managerย
Department:ย Clinical Operationsย
Job Description:ย
Patient Call Management & Communicationย
Insurance Verification & Eligibility Determinationย
Enrollment Pipeline Supportย
Administrative &ย Platformย Supportย
Technology & Data Accuracyย
Qualificationsย and Skills Required:ย
1โ3 years of experience in healthcare administration, patient access, insurance verification, or care coordination supportย
Competencies:ย
Competencyย
Definitionย
Patient Communicationย
Provides clear, compassionate communication whenย assistingย patients.ย
Insurance Verificationย
Demonstratesย strongย understanding of insurance coverage and eligibility processes.ย
Technical Acumenย
Navigates EMR systems and healthcare technology platforms efficiently.ย
Attention to Detail.ย
Ensuresย accuracy in documentation and patient data entry.ย ย
Compliance Awarenessย
Maintains HIPAA compliance and proper handling of protected health information.ย
Organizationย
Manages multiple tasks and systems effectively in a fast-paced environment.ย
Collaborationย
Works closely withย Enrollment Specialists, Care Coordinators, and operations staff.ย
Key Performance Indicators (KPIs)ย
Work Location, Shift & Scheduleย
This position is remote (please see remote requirements below).ย Shifox/Alopexย employees work Monday-Friday r according to the business hours of client practices.
Remote Position Requirements:ย
Reliable and stable Internet โ all programs used by Patient Access & Eligibility Specialistย are internet based.ย A quiet and professional work environment suitable for speaking with patients about sensitive information and Protected Health Information (PHI), free of distractions.ย
Compensation:
Contractors are paid on a monthly basis, see below.ย
Rate$17.00-$18.00 per hour