Healthcare Solutions is a leading provider of Revenue Cycle Management (RCM) and Risk Adjustment services, helping healthcare organizations optimize operations, improve financial performance, maintain compliance, and enhance the patient experience. Recognized as a KLAS® Top Performer, combines innovative technology, industry expertise, and a commitment to excellence to deliver measurable results for clients across the healthcare industry. We are dedicated to being a trusted healthcare partner by upholding the highest standards of quality, information security, and compliance.

At , we foster a collaborative and growth-oriented culture where employees are empowered to develop their skills, advance their careers, and make a meaningful impact in transforming healthcare.

Patient Intake and Referral Management

• Manage inbound patient and referral inquiries from patients, families, healthcare providers, care coordinators, discharge planners, payer representatives, and other referral sources.

• Conduct standardized intake screening to determine service eligibility, payer requirements, coverage, and appropriate next steps.

• Collect and validate patient demographic, insurance, referral, and other information required to support accurate registration and reimbursement.

• Coordinate eligible patients through the intake process with the goal of completing registration and scheduling efficiently.

• Follow up on incomplete referrals, missing documentation, and outstanding intake requirements.

• Communicate clearly with patients and referral sources regarding required documentation, insurance requirements, scheduling, and next steps.

Eligibility and Benefits Verification

• Verify insurance eligibility and benefits in real time using payer portals and direct payer communication.

• Confirm active coverage, plan type, network status, deductibles, copays, out-of-pocket requirements, visit limitations, and other applicable benefit information.

• Identify prior authorization requirements and ensure authorization needs are initiated or appropriately routed before services are provided.

• Understand and apply the distinction between insurance eligibility, benefits, prior authorization, and medical necessity requirements.

• Accurately document verified insurance and benefit information within applicable EHR, practice management, and revenue cycle systems.

• Escalate discrepancies in coverage or payer requirements to appropriate revenue cycle or operational teams.

Scheduling and Patient Access Coordination

• Schedule eligible patients for appropriate services following completion of required intake and payer verification activities.

• Provide patients with accurate appointment information and instructions regarding required forms or documentation.

• Coordinate with operational, clinical, authorization, and billing teams when additional information or action is required before scheduling.

• Track scheduled appointments and support follow-up activities related to cancellations, no-shows, or incomplete intake requirements.

• Maintain timely communication with referral sources regarding intake status and outstanding requirements.

Revenue Cycle Support

• Support clean front-end revenue cycle processes by ensuring demographic, insurance, eligibility, benefit, and authorization information is accurate before services are rendered.

• Identify potential reimbursement barriers during intake and escalate them before they result in avoidable denials or delayed payment.

• Coordinate with authorization, billing, and other RCM teams to resolve payer-related issues.

• Maintain knowledge of payer requirements and workflow changes affecting patient access and reimbursement.

• Support process improvements designed to increase intake completion, scheduling conversion, documentation accuracy, and clean claim performance.

Documentation and Compliance

• Maintain complete and accurate intake documentation within applicable healthcare systems.

• Document referral source, payer information, eligibility and benefit verification, authorization status, appointment information, and required follow-up.

• Maintain patient confidentiality and comply with HIPAA and applicable healthcare privacy requirements.

• Support accurate records for payer audits, internal quality reviews, and revenue cycle reporting.

• Follow established documentation standards and quality requirements.

Performance and Quality

• Meet established performance expectations related to intake completion, conversion, documentation accuracy, call quality, and first-contact resolution.

• Maintain accuracy while working in a high-volume environment.

• Participate in quality reviews, coaching, training, and workflow improvement initiatives.

• Identify recurring intake or payer issues and communicate opportunities for process improvement.

Qualifications

• Minimum of two years of experience in healthcare intake, patient access, admissions, insurance verification, or another front-end Revenue Cycle Management function.

• Prior intake, patient access, or RCM experience supporting behavioral health services is required.

• Experience verifying insurance eligibility and benefits using payer portals such as Availity, NaviNet, or similar systems.

• Working knowledge of insurance eligibility, benefits, prior authorization, and payer requirements.

• Experience working with commercial and managed care insurance plans.

• Experience using EHR, practice management, or other healthcare revenue cycle systems.
• MediCal experience preferred.

• Ability to manage multiple systems and workflows simultaneously while communicating with patients or referral sources.

• Strong verbal and written communication skills.

• Strong attention to detail and ability to maintain accurate patient and payer information.

• Working knowledge of HIPAA and healthcare confidentiality requirements.

• Ability to communicate professionally with patients, families, healthcare providers, payer representatives, and internal teams.

Requirements

• Associate degree or higher in healthcare administration, business, psychology, social work, public health, or a related field.

• Experience in patient access, admissions coordination, healthcare call center, or centralized intake operations.

• Experience working across multiple payer types and healthcare service lines.

• Experience identifying and coordinating prior authorization requirements during the intake process.

• Experience working in a performance-driven intake or patient access environment.
• Bilingual English/Spanish communication skills preferred.
• Candidate will need to be able to support a work schedule in the Pacific time zone.

• US based candidates eligible for employment without sponsorship.