Job Description:

• Collect, verify, and maintain patient demographic, insurance, and clinical information
• Review patient accounts for completeness and resolve registration discrepancies before scheduled services
• Ensure required documentation is complete and accurately recorded
• Verify insurance eligibility, benefits, referrals, and authorization requirements across various payer types
• Obtain, monitor, and document prior authorizations and referrals
• Investigate and independently resolve complex insurance eligibility, authorization, and coverage issues
• Communicate authorization requirements, financial responsibility, and coverage concerns to patients, providers, and internal stakeholders
• Communicate fluently in Spanish and English with patients, families, and providers by phone and in writing
• Explain insurance eligibility, prior authorization requirements, financial responsibility, and appointment instructions in Spanish
• Document Spanish-language interactions in English within the EMR and other assigned systems
• Recognize when qualified medical interpreters are needed and follow language access procedures
• Serve as a Spanish-language resource for team members and help improve experiences for patients with limited English proficiency
• Schedule, reschedule, and coordinate appointments according to client and provider guidelines
• Handle escalated patient, provider, and client inquiries
• Resolve complex scheduling and patient access issues while delivering exceptional customer service
• Build collaborative relationships with provider offices, insurance carriers, and internal departments
• Maintain complete, accurate, and timely documentation across assigned systems
• Ensure compliance with HIPAA, client requirements, payer guidelines, and organizational policies
• Identify documentation or workflow issues and take corrective action
• Meet and exceed productivity, quality, attendance, service, and other team metrics
• Assist with onboarding and training new team members by sharing knowledge and best practices
• Identify workflow inefficiencies and recommend process improvements
• Adapt to changing payer requirements, client expectations, and operational priorities
• Participate in departmental meetings, quality initiatives, and continuous improvement efforts
• Perform other duties as assigned

Requirements:

• High school diploma or GED required
• Fluency in spoken and written Spanish and English required; a language proficiency assessment is part of the hiring process
• One to four years of Patient Access, Medical Scheduling, Registration, or related healthcare experience required
• Demonstrated ability to independently verify insurance eligibility, obtain prior authorizations, and manage appointment scheduling
• Experience resolving moderately complex insurance, authorization, or patient access issues with minimal guidance
• Ability to explain healthcare and insurance terms in Spanish, such as deductible, copay, prior authorization, Medicaid, and Medicare
• Working knowledge of commercial insurance, Medicare, Medicaid, and managed care plans
• Experience using electronic medical record (EMR) systems such as Epic or Cerner preferred
• Familiarity with Spanish medical terminology preferred
• Cultural awareness and sensitivity when serving diverse patient populations, including familiarity with regional variations in Spanish
• Excellent customer service, communication, organizational, and problem-solving skills
• Proficiency with Microsoft Office and web-based healthcare applications
• Ability to manage multiple priorities while maintaining a high level of accuracy and professionalism
• Ability to work independently in a remote environment with limited day-to-day oversight
• Reliable high-speed internet and a private, quiet, and focused workspace that protects patient confidentiality
• Occasional overtime may be required based on business needs

Benefits:

• Employer sponsored Medical, Dental & Vision
• HSA Employer Contributions
• Employer Paid Life Insurance
• Short-term and Long-term Disability Insurance Plans
• AD&D Insurance Plans
• Flexible Time Off Plan
• Paid Holidays
• Employee Referral Bonus