Consumer Access Specialist

AdventHealth•Orlando, FL

1d•Onsite

About The Position

The Consumer Access Specialist supports patient access and revenue cycle operations at AdventHealth Waterford Lakes ER. The role registers patients for services, verifies insurance coverage, obtains pre-authorizations, prepares estimates of patient financial responsibility, and collects payments or arranges payment plans. It also performs Medicare compliance reviews and issues Advance Beneficiary Notices of Noncoverage when needed. The specialist coordinates with utilization management and other departments, supports patient communications, documents interactions, performs cashiering functions, and provides switchboard coverage as needed. The position is scheduled Monday through Thursday from 12 p.m. to 10 p.m. at AdventHealth Waterford Lakes ER in Orlando, Florida. The pay range is $16.79 to $26.86. A high school diploma or equivalent is required; an associate degree is preferred. Relevant customer service, healthcare, and revenue cycle experience are preferred. CHAA and CRCR certifications are also preferred. Additional licensure or certification requirements may apply depending on the unit or state.

Requirements

High school diploma or equivalent 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 machines, including a computer, fax machine, printer, and scanner.
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.
Adherence to government guidelines such as CMS, EMTALA, and HIPAA, and to corporate policies.
Understanding of HIPAA privacy rules and 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 interpret insurance benefit information.
Exceptional customer service skills.
Bilingual English/Spanish ability.
Additional licensure or certification requirements may apply depending on the unit or state.

Nice To Haves

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

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 regarding pre-authorization issues and provide patients with necessary logistical information.
Contact insurance companies to verify eligibility and benefits, and obtain pre-authorizations within established timeframes.
Register patients for services, ensuring accuracy and minimizing duplication of medical records.
Collect patient demographic information and confirm insurance details.
Provide continuous 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 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 cash reconciliation.
Perform other duties as assigned.