Consumer Access Specialist Emergency Full-Time Evenings

AdventHealth•Mission, TX

12h•Onsite

About The Position

Performs Medicare compliance reviews and issues Advance Beneficiary Notices of Noncoverage as needed. Creates accurate estimates for patient financial responsibility and collects payments or establishes payment plans. Coordinates with utilization management staff for pre-authorization issues and ensures patients have necessary logistical information. Contacts insurance companies to verify eligibility and benefits, and obtains pre-authorizations within established timeframes. Registers patients for all services, ensuring accuracy and minimizing duplication of medical records. Collects critical demographic information from patients and confirms insurance details. Provides timely and continual coverage of assigned work areas during scheduled shifts, arranging relief coverage as needed. Manages communication between clinical, ancillary, and consumer access departments to enhance the patient experience. Consistently provides excellent customer service, documenting all patient and insurance representative conversations, including payer decisions and payment arrangements. Attends department meetings and promotes positive dialogue within the team. Provides coverage for PBX (Switchboard) as needed, including answering phones and transferring calls. Performs cashiering functions such as collections and cash reconciliation accurately. Other duties as assigned.

Requirements

Mature judgement in dealing with patients, physicians, and insurance representatives
Working knowledge of Microsoft programs and familiarity with database programs
Ability to operate general office machines such as computer, fax machine, printer, and scanner
Ability to effectively learn and perform multiple tasks, and organize work in a systematic and efficient fashion
Ability to communicate professionally and effectively, both verbally and written
Ability to adapt in ever-changing healthcare environment
Ability to follow complex instructions and procedures, with a close attention to detail
Adheres to government guidelines such as CMS, EMTALA, and HIPAA and corporate policies
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
High School Grad or Equiv [Required]

Nice To Haves

Associate [Preferred]
Experience in Customer Service related field
Exceptional customer service skills
Advanced understanding of insurance knowledge and benefits
Advanced understanding of hospital electronic medical report (EMR) system
Intermediate medical terminology
1+ customer service [Preferred]
1+ relevant healthcare [Preferred]
1+ revenue cycle [Preferred]
Certified Healthcare Access Associate (CHAA) [Preferred]
Certified Revenue Cycle Rep (CRCR) [Preferred]

Responsibilities

Performs Medicare compliance reviews and issues Advance Beneficiary Notices of Noncoverage as needed.
Creates accurate estimates for patient financial responsibility and collects payments or establishes payment plans.
Coordinates with utilization management staff for pre-authorization issues and ensures patients have necessary logistical information.
Contacts insurance companies to verify eligibility and benefits, and obtains pre-authorizations within established timeframes.
Registers patients for all services, ensuring accuracy and minimizing duplication of medical records.
Collects critical demographic information from patients and confirms insurance details.
Provides timely and continual coverage of assigned work areas during scheduled shifts, arranging relief coverage as needed.
Manages communication between clinical, ancillary, and consumer access departments to enhance the patient experience.
Consistently provides excellent customer service, documenting all patient and insurance representative conversations, including payer decisions and payment arrangements.
Attends department meetings and promotes positive dialogue within the team.
Provides coverage for PBX (Switchboard) as needed, including answering phones and transferring calls.
Performs cashiering functions such as collections and cash reconciliation accurately.
Other duties as assigned.