Access Coordinator II - M-F, 8a-4:30p

PRIMARY FUNCTION:

Serves as a critical member of the Patient Access team, responsible for ensuring timely, accurate, and seamless access to care through comprehensive patient access and authorization activities. Promotes a high-quality patient and provider experience by proactively verifying benefits, obtaining prior authorizations, and coordinating services in alignment with payer requirements and clinical guidelines. Supports organizational goals related to access, compliance, and revenue integrity by minimizing delays in care, reducing authorization-related denials, and ensuring financial accountability across the patient encounter.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

Performs daily patient access operations, including registration, insurance verification, and encounter management, ensuring accuracy, completeness, and compliance with organizational standards.

Initiates, obtains, and manages prior authorizations for scheduled services in accordance with payer requirements, medical necessity criteria, and clinical documentation standards.

Reviews and interprets clinical documentation to support authorization submissions and ensure alignment with payer guidelines.

Proactively monitors and follows up on pending authorizations to prevent delays in care and mitigate risk of denials or rescheduled services.

Communicates authorization status, barriers, and required actions to providers, clinical teams, and leadership in a timely and professional manner.

Collaborates with physicians, clinical staff, and ancillary departments to ensure all required authorizations are secured prior to service delivery.

Identifies and escalates complex or urgent authorization issues that may impact patient care, access, or financial outcomes.

Reviews, researches, and assists in resolving authorization-related denials, discrepancies, or payer rejections in collaboration with revenue cycle and clinical partners.

Accurately registers patient encounters, ensuring all demographic, insurance, and financial information is validated and compliant with regulatory and organizational requirements.

Determines and collects pre-service and point-of-service payments, including outstanding balances, in accordance with established guidelines.

Educates patients on insurance coverage, financial responsibility, authorization requirements, and available financial assistance options to support informed decision-making.

Maintains a strong working knowledge of third-party payer requirements, authorization processes, and benefit structures, applying this knowledge to daily workflows.

Ensures adherence to regulatory requirements, payer policies, and organizational standards related to patient access and authorization activities.

Identifies trends, barriers, and opportunities related to authorizations, delays, or denials, and escalates for process improvement and operational optimization.

Performs assigned responsibilities in a manner that supports a culture of safety, quality, accountability, and patient-centered care.

SCOPE, PURPOSE, AND FREQUENCY OF CONTACTS:

Maintains frequent, ongoing interaction with patients and family members to obtain information, provide education, and facilitate a seamless access experience.

Engages daily with physicians, clinical staff, and departmental teams to coordinate care, ensure authorization readiness, and support timely service delivery.

Communicates regularly with insurance payers to verify benefits, obtain prior authorizations, clarify requirements, and resolve issues impacting patient care and financial outcomes.

Collaborates with revenue cycle teams, financial counseling, and internal support departments to ensure alignment across patient access, authorization, and billing processes.

Interacts with cross-functional teams across outpatient, inpatient, emergency department, and call center settings to support coordinated, enterprise-wide patient access operations.

EDUCATION AND EXPERIENCE REQUIREMENTS:

Minimum High School diploma required.

Two years experience in a medical, financial or marketing institution preferred.

Previous insurance or third-party experience is preferred

An equivalent combination of education and experience may be substituted.

KNOWLEDGE, SKILL, AND ABILITY REQUIREMENTS:

Demonstrates strong knowledge of patient access workflows, including registration, insurance verification, and authorization processes.

Working knowledge of payer authorization requirements, medical necessity criteria, and insurance benefit structures.

Ability to interpret clinical documentation and apply payer guidelines to support successful authorization outcomes.

Demonstrates critical thinking and problem-solving skills, with the ability to assess situations, identify barriers, and implement effective solutions.

Strong organizational and prioritization skills, with the ability to manage high-volume, time-sensitive work while maintaining accuracy and attention to detail.

Ability to effectively communicate both verbally and in writing with patients, providers, payers, and internal stakeholders.

Demonstrates strong customer service skills with a focus on patient-centered care and service excellence.

Ability to manage multiple systems, applications, and workflows simultaneously, including electronic health records such as Epic.

Ability to work independently and collaboratively within a team environment while adhering to established guidelines and expectations.

Demonstrates adaptability and the ability to perform effectively in a fast-paced, evolving healthcare environment.

Exhibits professionalism, accountability, and alignment with organizational core values.

Christiana Care Health System is an equal opportunity employer, firmly committed to prohibiting discrimination, whose staff is reflective of its community, and considers qualified applicants for open positions without regard to race, color, sex, religion, national origin, sexual orientation, genetic information, gender identity or expression, age, veteran status, disability, pregnancy, citizenship status, or any other characteristic protected under applicable federal, state, or local law.

Post End Date

EEO Posting Statement

ChristianaCare offers a competitive suite of employee benefits to maximize the wellness of you and your family, including health insurance, paid time off, retirement, an employee assistance program. To learn more about our benefits for eligible positions visit https://careers.christianacare.org/benefits-compensation/