Consumer Access Specialist

AdventHealth; Aurora (CO); On-site; USD 28,000 - 44,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Life insurance

Disability insurance

PTO

403-B retirement plan

Parental leave

Career development

Well-being resources

Mental health support

Pet benefits

Job summary

AdventHealth in Aurora, Colorado seeks a patient access specialist to perform Medicare compliance reviews, estimate patient responsibility, and coordinate with insurance for pre-authorizations. You will register patients, collect payments, and ensure accurate records while supporting multiple departments for a seamless patient experience.

The role emphasizes strong customer service, knowledge of EMR systems, and adherence to HIPAA and CMS guidelines; bilingual skills and prior revenue-cycle or

Qualifications

• Mature judgement in 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 computer, fax machine, printer, and scanner.
• Ability to effectively learn and perform multiple tasks, and organize work in a systematic and efficient fashion.
• Ability to communicate professionally and effectively, both verbally and written.
• Ability to adapt in ever-changing healthcare environment.
• Ability to follow complex instructions and procedures, with a close attention to detail.
• Adheres to CMS EMTALA HIPAA and corporate policies.
• Understanding of HIPAA privacy rules and discretion with patient information.
• Knowledge of EMR systems and computer programs.
• Basic knowledge of medical terminology.
• Exposure to insurance benefits; ability to decipher benefit information.
• Bilingual – English/Spanish
• Experience in Customer Service field
• Exceptional customer service skills
• Advanced understanding of insurance knowledge and benefits
• Advanced understanding of hospital EMR system
• Intermediate medical terminology

Responsibilities

• Perform Medicare compliance reviews and prepare Advance Beneficiary Notices of Noncoverage.
• Create accurate estimates of patient financial responsibility and collect payments or arrange plans.
• Coordinate with utilization management for pre-authorization issues and provide necessary information to patients.
• Verify insurance eligibility and benefits; obtain pre-authorizations within timeframes.
• Register patients for services with accurate demographic and insurance data; minimize duplicate medical records.
• Provide timely coverage of assigned work areas and arrange relief as needed.
• Communicate between clinical, ancillary, and access departments to improve patient experience.
• Maintain thorough documentation of conversations with patients and insurers, including payer decisions.
• Attend department meetings and contribute to positive team dialogue.
• Provide PBX coverage and perform cashiering duties as required.

Education

Associate degree preferred

High school diploma required

Job description

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-Weekend (United States of America)

Address:

6159 S Southlands Pkwy

City:

Aurora

State:

Colorado

Postal Code:

80016

Job Description:

Performs Medicare compliance reviews and issues Advance Beneficiary Notices of Noncoverage as needed. Creates accurate estimates for patient financial responsibility and collects payments or establishes payment plans. Coordinates with utilization management staff for pre-authorization issues and ensures patients have necessary logistical information. Contacts insurance companies to verify eligibility and benefits, and obtains pre-authorizations within established timeframes. Registers patients for all services, ensuring accuracy and minimizing duplication of medical records. Collects critical demographic information from patients and confirms insurance details. Provides timely and continual coverage of assigned work areas during scheduled shifts, arranging relief coverage as needed. Manages communication between clinical, ancillary, and consumer access departments to enhance the patient experience. Consistently provides excellent customer service, documenting all patient and insurance representative conversations, including payer decisions and payment arrangements. Attends department meetings and promotes positive dialogue within the team. Provides coverage for PBX (Switchboard) as needed, including answering phones and transferring calls. Performs cashiering functions such as collections and cash reconciliation accurately. Other duties as assigned.

Knowledge, Skills, and Abilities:

• Mature judgement in 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 computer, fax machine, printer, and scanner
• Ability to effectively learn and perform multiple tasks, and organize work in a systematic and efficient fashion
• Ability to communicate professionally and effectively, both verbally and written
• Ability to adapt in ever-changing healthcare environment
• Ability to follow complex instructions and procedures, with a close attention to detail
• Adheres to government guidelines such as CMS, EMTALA, and HIPAA and corporate policies
• 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
• Knowledge of computer programs and electronic health record programs
• Basic knowledge of medical terminology
• Exposure to insurance benefits; ability to decipher insurance benefit information
• Bilingual – English/Spanish
• Experience in Customer Service related field
• Exceptional customer service skills
• Advanced understanding of insurance knowledge and benefits
• Advanced understanding of hospital electronic medical report (EMR) system
• Intermediate medical terminology

Education:

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

Field of Study:

N/A

Work Experience:

• 1+ customer service [Preferred]
• 1+ relevant healthcare [Preferred]
• 1+ revenue cycle [Preferred]

Additional Information:

• N/A

Licenses and Certifications:

• Certified Healthcare Access Associate (CHAA) [Preferred]
• Certified Revenue Cycle Rep (CRCR) [Preferred]

Physical Requirements:

Physical Requirements - https://tinyurl.com/23km2677

Pay Range:

$19.97 - $31.95

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