Consumer Access Specialist

All the benefits and perks you need for you and your family:Benefits from Day OnePaid Days Off from Day OneStudent Loan Repayment ProgramCareer DevelopmentWhole Person Wellbeing ResourcesMental Health Resources and SupportPet Insurance Debt-free Education (Certifications and Degrees without out-of-pocket tuition expense)Our promise to you:Joining AdventHealth is about being part of something bigger.
Its 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: Part TimeShift : Monday - Friday 7:30am - 2:00pmLocation: 400 CELEBRATION PLACE, Celebration, 34747The community you'll be caring for:Faith based & mission driven organizationCentral Floridas premier multi-specialty medical groupComprehensive Employee Benefits such as Educational ReimbursementCREATION Health employee wellness and lifestyle programsPositive working climate to support a work life balanceThe role you'll contribute:Ensures patients are appropriately financially cleared for all appointments.
Performs eligibility verification, obtains pre-cert and/or authorizations, clears registration errors and edits pre-bill, and performs 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.The value you'll bring to the team:Proactively contacts insurance companies by phone, fax, online portal, and other resources to obtain and verify insurance eligibility and benefits and determine extent of coverage within established timeframe before scheduled appointments and during or after care for unscheduled patientsMeet department standard when obtaining 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 medicationMaintain close working relationship with clinical partners and physician offices to resolve issues with obtaining pre-authorizations.
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 neededMinimizes duplication of medical records by using problem-solving skills to verify patient identity through demographic detailsEnsures patient accounts are assigned the appropriate payor plansEnsures all financial assessments, eligibility, and benefits are updated and thorough to support post care financial needs.
Uses utmost caution that obtained benefits, authorizations, and pre-certifications are correct and as accurate as possible to avoid rejections and/or denials.
Maintains a current and thorough knowledge of utilizing online eligibility pre-certification tools made availableThoroughly documents all conversations with patients and insurance representatives - including payer decisions, collection attempts, and payment plan arrangementsCoordinates with case management staff as necessary (e.g., when pre-authorization cannot be obtained for an inpatient stay)Adheres to HIPAA regulations by verifying information to determine caller authorization level receiving information on account.Creates accurate estimates to maximize up-front cash collections and adds collections documentation where requiredCalculates patients co-pays, deductibles, and co-insurance.
Provides personalized estimates of patient financial responsibility based on their insurance coverage or eligibility for government programs prior to service for both inpatient and outpatient servicesQualificationsThe expertise and experiences you'll need to succeed:Required:One year of customer service experienceHigh School diploma or GEDThis 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 ServicesOrganization: AdventHealth CelebrationSchedule: Part-timeShift: 1 - DayReq ID: 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.