Pre-Access Coordinator

Job Overview

The Pre-Access Specialist is responsible for verifying insurance coverage and benefits for physician, hospital, and surgery center appointments, securing authorizations associated to ordered procedure and engaging with patients regarding financial responsibility and collections.. This role works closely with payers, surgical center & physician offices, and patients to ensure accurate and timely verification of benefits, while supporting a positive financial experience for patients through clear communication and proactive payment planning.

Job Duties & Responsibilities

• Verify insurance eligibility, benefits, and network participation for physician offices, hospitals, and ambulatory surgery centers.
• Secure authorizations for ordered procedures within dedicated time lines.
• Coordinate with clinical team as necessary related to unattainable authorizations and possible procedure delays.
• Contact payers and utilize electronic verification tools to confirm coverage and benefit information.
• Maintain knowledge of commercial and government insurance plans, including HMO, PPO, POS, and Open Access plans.
• Verify coverage details including effective dates, copays, deductibles, coinsurance, out-of-pocket amounts, and group information.
• Accurately enter and update insurance information to support billing, referrals, and account accuracy.
• Review insurance coverage for same-day and upcoming appointments and resolve eligibility issues proactively.
• Research and correct insurance discrepancies, linking patients and guarantors to the appropriate coverage.
• Communicate with provider offices to obtain missing information and resolve verification concerns.
• Obtain required authorizations, and pre-certifications to support timely patient care and reimbursement.
• Prepare patient cost estimates and explain financial responsibility based on insurance benefits.
• Contact patients regarding coverage, estimated balances, and payment arrangement options
• Handle insurance verification, financial counseling, and patient account inquiries while meeting productivity standards.
• Maintain HIPAA compliance, support process improvement initiatives, and collaborate effectively with team members and stakeholders.

Position Requirements & Qualifications

• High school diploma or equivalent required.
• Minimum 1-2 years of experience in insurance verification, patient access, revenue cycle, medical billing, healthcare customer service, or a related healthcare setting.
• Experience using EMR systems such as Meditech, Epic, Cerner, Allscripts, Nextgen, HST/Clarity, Waystar, or similar platforms to support billing and account resolution.
• Proficiency in Microsoft Office Suite (Word, Excel, Outlook, PowerPoint, Teams) and other business software, with a commitment to professionalism, integrity, and fostering positive workplace relationships.

Knowledge, Skills & Abilities

• Proficient in using electronic insurance verification tools and online resources to validate coverage and benefits.
• Working knowledge of commercial and government insurance plans, including HMO, PPO, POS, and Open Access plans.
• Strong attention to detail with the ability to accurately review, maintain, and update insurance and account information.
• Excellent verbal and written communication skills, including the ability to explain insurance benefits, financial responsibility, and payment options to patients.
• Strong organizational, time management, and multitasking skills with the ability to prioritize work, manage high account volumes, and meet productivity goals.
• Ability to handle sensitive financial conversations with professionalism, discretion, and a customer-focused approach.
• Demonstrated ability to work independently and collaboratively in a team environment while maintaining reliability, punctuality, and excellent attendance.

Disclosure Statement:
As part of the Currance application and hiring experience, all candidates are subject to a criminal background check, employment verification check and a government exclusion check. The government exclusion check is a mandatory screening process that verifies whether an individual is listed on federal or state exclusion or watchlists, including but not limited to, the Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) and the System for Award Management (SAM.gov).
These screenings are conducted to ensure compliance with applicable federal and state laws and regulations, to protect the integrity of federally funded programs, the clients we support, and to prevent participation by individuals who are excluded due to fraud, abuse, or other misconduct. By submitting an application, candidates acknowledge and consent to these checks as a condition of employment or engagement.