Patient Access & Insurance Specialist Job at Orthopaedic Associates of Maine, Portland, OR

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  • Orthopaedic Associates of Maine
  • Portland, OR

Job Description

 

DEPARTMENT: Patient Access

REPORTS TO: Patient Access Manager

FLSA STATUS: Non-Exempt

POSITION SUMMARY
The Patient Access & Insurance Specialist serves as a subject matter expert in patient insurance eligibility, benefits, and point-of-service collections. This role supports patients and clinic staff by providing in-person financial guidance, assisting with insurance-related questions, and ensuring accurate encounter-level insurance review. The Patient Access Specialist works closely with the Patient Access Manager, front desk staff, Revenue Cycle Management (RCM), and the IBT Call Center to ensure a smooth patient experience and proper financial processes.

SUPERVISES

N/A

PRIMARY RESPONSIBILITIES

· Serve as a subject matter expert for patient insurance eligibility and benefits.

· Conduct encounter-level insurance reviews to ensure accuracy prior to or at time of service.

· Collect in-person surgical and procedure deposits.

· Assist front desk staff with time-of-service collections, including copays, deductibles, and outstanding balances.

· Address in-person patient billing and insurance questions with professionalism and clarity.

· Manage and assist with in-person bad debt discussions and resolution.

· Complete insurance-related PM tasks originating from the appointment center, NG eligibility processes, and clinic teams.

· Escalate patient questions to the appropriate Growth Ortho RCM team or IBT Call Center when unable to resolve independently.

· Identify training gaps and advise the Patient Access Manager of PSR training needs.

· Provide insurance training and education as needed.

· Collaborate with internal teams to ensure consistent communication and accurate financial workflows.

· Manage the insurance card email inbox.

· Enroll patients in payment plans during in-person visits.

· Maintain provider portal access and determine eligibility.

· Provide coverage for front desk check-in process as needed.

QUALIFICATIONS

· Strong knowledge of insurance eligibility, benefits, and patient financial responsibility.

· Experience with point-of-service collections and patient financial counseling.

· Excellent communication and customer service skills.

· Ability to problem-solve and escalate issues appropriately.

· Familiarity with practice management systems and insurance verification processes.

· Ability to work collaboratively in a fast-paced, patient-facing environment.

PHYSICAL DEMANDS / WORK ENVIRONMENT

· This position is primarily performed in an office and clinical setting.

· The role requires prolonged periods of sitting, including working at a computer and desk.

· Occasional standing and walking throughout the clinic or office area is required.

· May require occasional lifting, carrying, or moving items up to 10 pounds, such as files, office supplies, or small equipment.

· Requires the ability to communicate effectively with patients, providers, and staff in person and by phone.

· Must be able to use standard office equipment, including computers, phones, printers, and scanners.

· Work environment is generally quiet to moderately busy, with frequent patient and staff interaction

ADDITIONAL NOTES

This job description outlines the core duties of the role. It is not an exhaustive list and may evolve with the needs of the practice. The role is designed to support excellence in patient care, enhance clinical operations, and contribute to a positive patient experience.

Job Tags

Full time, Work at office,

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