Consumer Access Representative

Our promise to you:

Joining AdventHealth is about being part of something bigger. It’s 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.

All the benefits and perks you need for you and your family:

• Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance

• Paid Time Off from Day One

• 403-B Retirement Plan

• 4 Weeks 100% Paid Parental Leave

• Career Development

• Whole Person Well-being Resources

• Mental Health Resources and Support

• Pet Benefits

Schedule:

Full time

Shift:

Day (United States of America)

Address:

701 E ALTAMONTE DR

City:

ALTAMONTE SPRINGS

State:

Florida

Postal Code:

32701

Job Description:

Contacts insurance companies to obtain and verify insurance eligibility and benefits within established timeframes before scheduled appointments and during or after care for unscheduled patients. Obtains pre-authorizations from third-party payers in accordance with payer requirements and accurately enters required authorization information in the system. Verifies medical necessity in accordance with appropriate standards and communicates relevant coverage/eligibility information to patients. Corrects demographic, insurance, or authorization-related errors and pre-bill edits to ensure the integrity of patient accounts. Monitors work queues throughout the day to ensure patient accounts are worked timely and in accordance with established expectations. Creates accurate estimates to maximize up-front cash collections and adds collections documentation where required. Calculates patients’ co-pays, deductibles, and co-insurance, providing personalized estimates of financial responsibility based on insurance coverage. Minimizes duplication of medical records by verifying patient identity through demographic details. Coordinates with case management staff as necessary, especially when pre-authorization cannot be obtained for an inpatient stay. Actively attends department meetings and promotes positive dialogue within the team. Meets and exceeds productivity standards determined by department leadership and maintains schedule flexibility to meet department needs. Other duties as assigned.Knowledge, Skills, and Abilities:

• Mature judgement in dealing with patients, physicians, and insurance representatives [Required]
• Working knowledge of Microsoft programs and familiarity with database programs [Required]
• Ability to operate general office machines such as computer, fax machine, printer, and scanner [Required]
• Ability to effectively learn and perform multiple tasks, and organize work in a systematic and efficient fashion [Required]
• Ability to communicate professionally and effectively, both verbally and written [Required]
• Ability to adapt in ever changing healthcare environment [Required]
• Ability to follow complex instructions and procedures, with a close attention to detail [Required]
• Adheres to government guidelines such as CMS, EMTALA, and HIPAA and corporate policies [Required]
• 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 [Preferred]
• Knowledge of computer programs and electronic health record programs [Preferred]
• Basic knowledge of medical terminology [Preferred]
• Exposure to insurance benefits; ability to decipher insurance benefit information [Preferred]
• Bilingual – English/Spanish [Preferred]

Education:

• Associate [Preferred]
• High School Grad or Equiv [Required]

Field of Study:

• in Business Administration, Health Services Administration, Communications, Finance Administration, or Accounting
• in Business Admin, Finance, Healthcare, or related field

Work Experience:

• 1 customer service experience [Preferred]
• 1 relevant healthcare experience [Preferred]
• Prior collections experience [Preferred]

Additional Information:

• N/A

Licenses and Certifications:

• N/A

Physical Requirements: (Please click the link below to view work requirements)
Physical Requirements - https://tinyurl.com/23km2677

Pay Range:

$15.69 - $25.10

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.