Consumer Access Specialist

All the benefits and perks you need for you and your family:

• Benefits from Day One
• Paid Days Off from Day One
• Student Loan Repayment Program
• Career Development
• Whole Person Wellbeing Resources

Our promise to you:

Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind, and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

Schedule: Full-time Shift: Day

Location: AdventHealth Porter

The role you'll contribute:

Ensures patients are appropriately registered for all service lines. Performs eligibility verification, obtains pre-cert and/or authorizations, makes financial arrangements, requests, and receives payments for services, performs cashiering functions, clears registration errors, and edits pre-bill, and other duties as required. Maintains a close working relationship with clinical partners to ensure continual open communication between clinical, ancillary, and patient access departments. Actively participates in extending exemplary service to both internal and external customers and accepts responsibility in maintaining relationships that are equally respectful to all. Provides PBX (switchboard) coverage and support as needed.

The value you'll bring to the team:

• Obtains pre-authorizations from third-party payers in accordance with payer requirements and within established timeframe before scheduled appointments and during or after care for unscheduled patients.
• Accurately enters required authorization information in AdventHealth systems to include length of authorization, total number of visits, and/or units of medication.
• Obtains PCP referrals when applicable.
• Conducts diligent follow-up on missing or incomplete pre-authorizations with third-party payers to minimize authorization related denials through phone calls, emails, faxes, and payer websites, updating documentation as needed.
• Submits notice of admissions when requested by facility.
• Corrects demographic, insurance, or authorization related errors and pre-bill edits.
• Meets or exceeds accuracy standards and ensures integrity of patient accounts by working error reports as requested by leadership and entering appropriate and accurate data.
• Minimizes duplication of medical records by using problem-solving skills to verify patient identity through demographic details.
• Responsible for registering patients by obtaining critical demographic elements from patients (e.g., name, date of birth, etc.)
• Registers patients for all services (i.e., emergency room, outpatient, inpatient, observation, same day surgery, outpatient in a bed, etc.) and achieves the department specific goal for accuracy.
• Confirms whether patients are insured and, if so, gathers details (e.g., insurer name, plan subscriber).
• Performs Medicare compliance review on all applicable Medicare accounts to determine coverage. Identifies patients who may need Medicare Advance Beneficiary Notices of Noncoverage (ABNs). Issues ABN forms as needed.

Qualifications

The expertise and experiences you’ll need to succeed:

Required:

• High School Grad or Equivalent and 1 plus years of experience.

Preferred:

• Associate's degree
• One year of relevant healthcare experience.
• Prior collections experience.
• One year of customer service experience.
• One year of direct Patient Access experience.
• Understanding of HIPAA privacy rules and ability to use discretion when discussing patient related information that is confidential in nature as needed to perform duties.
• Knowledge of computer programs and electronic health record programs.
• Basic knowledge of medical terminology.
• Exposure to insurance benefits; ability to decipher insurance benefit information.
• Bilingual – English/Spanish

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. The salary range reflects the anticipated base pay range for this position. Individual compensation is determined based on skills, experience and other relevant factors within this pay range. The minimums and maximums for each position may vary based on geographical location.

Category: Patient Financial Services

Organization: AdventHealth Porter

Schedule: Full-time

Shift: 1 - Day

Req ID: 24009362

We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.