Consumer Access Specialist Nights Port Charlotte

AdventHealth•Charlotte, NC

4d•Onsite

About The Position

The Consumer Access Specialist performs patient access and revenue-cycle functions, including Medicare compliance reviews, issuing Advance Beneficiary Notices of Noncoverage when needed, preparing estimates of patient financial responsibility, collecting payments, and arranging payment plans. The role registers patients, gathers and verifies demographic and insurance information, checks insurance eligibility and benefits, and obtains pre-authorizations within established timeframes. The specialist coordinates with utilization management staff on authorization issues and provides patients with necessary logistical information. The position provides scheduled-shift coverage for assigned work areas, coordinates relief coverage as needed, and communicates with clinical, ancillary, and consumer access departments to support the patient experience. It documents patient and insurance representative conversations, including payer decisions and payment arrangements, and provides customer service, cashiering, cash reconciliation, and PBX (switchboard) coverage as needed. Other duties may be assigned.

Requirements

High school graduation or equivalent is required.
Preferred: Associate degree.
Preferred: 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.
Demonstrate 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, such as a computer, fax machine, printer, and scanner.
Ability to learn and perform multiple tasks and organize work systematically and efficiently.
Ability to communicate professionally and effectively, verbally and in writing.
Ability to adapt to a changing healthcare environment and follow complex instructions and procedures with close attention to detail.
Follow government guidelines, including CMS, EMTALA, and HIPAA, as well as corporate policies; understand HIPAA privacy rules and use discretion when discussing confidential patient information.
Knowledge of computer and electronic health record programs and basic medical terminology.
Exposure to insurance benefits and ability to decipher insurance benefit information.
Exceptional customer service skills.
Bilingual in English and Spanish.
Advanced understanding of insurance knowledge and benefits and of the hospital electronic medical record system.

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.
Bilingual in English and Spanish.
Certified Healthcare Access Associate (CHAA) certification.
Certified Revenue Cycle Representative (CRCR) certification.

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 ensure patients have 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 duplicate medical records.
Collect critical demographic information and confirm insurance details.
Provide timely, continual coverage of assigned work areas during scheduled shifts and arrange relief coverage as needed.
Manage communication between clinical, ancillary, and consumer access departments to enhance 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.