Consumer Access Spec PRN Patient Access Lake Wales at AdventHealth

Date Posted: 10/14/2021

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Job Snapshot

  • Job Schedule
    Per Diem
  • Date Posted:
    10/14/2021
  • Job ID:
    21029292
  • Job Family
    Patient Financial Services
  • Shift
    1 - Day

Job Description


Description

YOU ARE REQUIRED TO SUBMIT A RESUME WITH YOUR APPLICATION!

Consumer Access Specialist - AdventHealth - Lake Wales

Location Address:  410 South 11th Street , Lake Wales, FL 33853

Top Reasons to work at AdventHealth -  Lake Wales

  • A historic community with a hometown family feel; voted “friendliest small town in FL”
  • Surrounded by golf courses, beautiful lakes, and outdoor adventures
  • The facility is just 20 minutes away from LEGOLAND Florida
  • Faith-based work environment
  • Great benefits

Work Hours/Shift:   Per Diem (open availability to all shifts)

You Will Be Responsible For:

  • 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 patients
  • Meet 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 medication
  • Maintain 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 needed
  • Minimizes duplication of medical records by using problem-solving skills to verify patient identity through demographic details
  • Ensures patient accounts are assigned the appropriate payor plans
  • Ensures 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 available
  • Thoroughly documents all conversations with patients and insurance representatives - including payer decisions, collection attempts, and payment plan arrangements
  • Coordinates 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 required
  • Calculates 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 services
Qualifications

REQUIRED:

  • One year of customer service experience 
  • High School diploma or GED 

PREFERRED:

  • One year of relevant healthcare experience
  • Prior collections experience
  • One year of customer service experience
  • One year of direct Patient Access experience
  • Associate’s degree

GENERAL SUMMARY:

Ensures patients are appropriately registered for all service lines. Performs eligibility verification, obtains pre-cert and/or authorizations, makes financial arrangements, requests and receives payments for services, performs cashiering functions, clears registration errors and edits pre-bill, and 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. Provides PBX (switchboard) coverage and support as needed.


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

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