Patient Access Insurance Coordinator

Company Overview Shriners Children’s is an organization that respects, supports, and values each other. Named as the 2025 best mid-sized employer by Forbes, we are engaged in providing excellence in patient care, embracing multi-disciplinary education, and research with global impact. We foster a learning environment that values evidenced based practice, experience, innovation, and critical thinking. Our compassion, integrity, accountability, and resilience define us as leaders in pediatric specialty care for our children and their families. With 20+ hospitals, outpatient clinics, ambulatory care centers and outreach locations across the globe, we provide excellent care to children up to age 18 regardless of their family’s ability to pay or insurance status. Please click here to learn more about our locations. Job Description The Patient Access Insurance Coordinator delivers support that is consistent with the strategic vision, goals, philosophy and direction of Shriners Hospitals for Children. The Coordinator is responsible for determining the status of a patient’s insurance eligibility/coverage by contacting the appropriate insurance or third party payor in accordance with Shriners Hospitals for Children policies and procedures, for assigned facilities. The Coordinator may also be called upon to assist assigned facilities with resolving their patient access edits in the bill scrubber. The Insurance Coordinator will have a thorough knowledge and understanding of Commercial, Managed Care, Medicaid, Managed Medicaid and Medicare payor guidelines and eligibility criteria. Key Responsibilities: Performs insurance verification functions for assigned SHC facilities. Updates encounters in SHCIS with the appropriate eligibility and COB status. Documents, in the health plan comment field on the encounter, all actions that have been taken on the account related to insurance verification. Updates health plan as needed based on feedback from the insurance company. Maintains a detailed level of knowledge of all payors’ authorization/referral guidelines and updates all appropriate fields in SHCIS to drive encounters to worklists Maintains a daily productivity log. Performs bill hold review for assigned facilities. Reviews assigned bill hold worklists in the bill scrubber and updates the SHCIS encounter to resolve the bill hold and release the claim Documents, in the health plan comment fields on the encounter, all actions that have been taken to resolve the bill hold Documents, in the bill scrubber, the action that was taken to resolve the bill hold and assigns back to the CBO Maintains a daily productivity log Plans and organizes the work and activities of area of responsibility to ensure department and corporate goals are met Coordinates and prioritizes assigned activities to achieve maximum productivity Makes recommendations to the Corporate Manager of Patient Access for quality and efficiency improvements. Identifies system issues, assists in identifying root causes of issues and submits recommendations to the Corporate Manager of Patient Access and IS department for resolution Completes special projects as directed by the Corporate Manager of Patient Access. Demonstrates a positive and professional image at all times when interacting with management, staff and others. Responds positively to necessary changes in the workplace Assumes responsibility for professional growth and development. Attends workshops and seminars, reads manuals and updates to maintain a high level of knowledge of all payor criteria Maintains professional competency, according to department policies, procedures and protocols This is s remote position with a schedule of Monday thru Friday 8AM - 5PM ET. Required Qualifications: 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 Preferred Qualifications: 3 years of experience working as an insurance verifier in an acute care hospital, physician practice setting or other healthcare setting Children's hospital experience The pay range for this position is $21.96 - $32.94. Compensation is determined based on years of relevant experience and departmental equity.