Consumer Access Specialist

AdventHealth•Orlando, FL

17h•Remote

About The Position

The Consumer Access Specialist supports patient access and revenue cycle operations by registering patients, verifying insurance information, obtaining pre-authorizations, and helping patients understand and meet their financial responsibilities. The role performs Medicare compliance reviews, issues Advance Beneficiary Notices of Noncoverage when needed, creates patient estimates, collects payments, and establishes payment plans. It also coordinates with utilization management staff and shares necessary logistical information with patients. The position provides coverage for assigned work areas during scheduled shifts, facilitates communication across clinical, ancillary, and consumer access departments, and delivers consistent customer service. The specialist documents conversations with patients and insurance representatives, performs cashiering and cash reconciliation, attends department meetings, and provides PBX/switchboard coverage as needed. Other duties may be assigned. This is a full-time remote position with a day schedule: Monday through Thursday, 10:30 a.m.–7:00 p.m. Eastern Time, and Friday, 8:30 a.m.–5:00 p.m. Eastern Time. The listed pay range is $16.79–$26.86.

Requirements

High school graduation or equivalent is required.
Mature judgment when dealing with patients, physicians, and insurance representatives.
Working knowledge of Microsoft programs and familiarity with database programs.
Ability to operate general office equipment, including computers, fax machines, printers, and scanners.
Ability to learn and perform multiple tasks and organize work systematically and efficiently.
Professional and effective verbal and written communication skills.
Ability to adapt to a changing healthcare environment.
Ability to follow complex instructions and procedures with close attention to detail.
Adhere to government guidelines, including CMS, EMTALA, and HIPAA, and corporate policies.
Understand HIPAA privacy rules and use discretion when discussing confidential patient information.
Knowledge of computer programs and electronic health record programs.
Basic knowledge of medical terminology.
Exposure to insurance benefits and ability to decipher benefit information.
Exceptional customer service skills.

Nice To Haves

Associate degree preferred.
Bilingual English/Spanish.
Advanced understanding of insurance knowledge and benefits.
Advanced understanding of hospital electronic medical record systems.
At least 1 year of customer service experience preferred.
At least 1 year of relevant healthcare experience preferred.
At least 1 year of revenue cycle experience preferred.
Certified Healthcare Access Associate (CHAA) preferred.
Certified Revenue Cycle Representative (CRCR) preferred.

Responsibilities

Perform Medicare compliance reviews and issue Advance Beneficiary Notices of Noncoverage as needed.
Create accurate estimates of patient financial responsibility, collect payments, and establish payment plans.
Coordinate with utilization management staff on pre-authorization issues and ensure patients receive necessary logistical information.
Contact insurance companies to verify eligibility and benefits, and obtain pre-authorizations within established timeframes.
Register patients for services accurately while minimizing duplicate medical records.
Collect patient demographic information and confirm insurance details.
Provide timely, continual coverage of assigned work areas during scheduled shifts and arrange relief coverage as needed.
Coordinate communication among clinical, ancillary, and consumer access departments to support the patient experience.
Provide excellent customer service and document conversations with patients and insurance representatives, including payer decisions and payment arrangements.
Attend department meetings and promote positive team dialogue.
Provide PBX/switchboard coverage as needed, including answering and transferring calls.
Perform cashiering functions, including collections and accurate cash reconciliation.
Perform other duties as assigned.