Consumer Access Specialist

adventhealth; Burleson (TX); On-site; USD 2,364,000 - 3,782,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

Paid Time Off

403-B Retirement Plan

Parental Leave

Job summary

Texas Health Huguley in Burleson, TX is seeking a Patient Access role focused on Medicare compliance reviews, patient financial counseling, and billing coordination. You will verify benefits, collect payments, and arrange payment plans while ensuring accurate registration and documentation across departments.

The role requires strong customer service, HIPAA knowledge, and EMR experience, with bilingual English/Spanish abilities highly valued in a fast-paced hospital setting.

Qualifications

• Experience in customer service and healthcare settings is preferred.
• Knowledge of HIPAA and privacy regulations is essential.
• Familiarity with EMR systems and computer software is required.

Responsibilities

• Process Medicare compliance reviews and estimate patient financial responsibility.
• Coordinate with utilization management for pre-authorizations.
• Verify insurance eligibility and obtain pre-authorizations within timeframes.

Skills

Customer Service

Bilingual English/Spanish

HIPAA privacy

EMR system

Microsoft Office

Communication

Multitasking

Attention to detail

Insurance knowledge

Data entry

Education

Associate

High School Diploma

Job description

Our promise to you:

Joining Texas Health Huguley 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. Texas Health Huguley 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:

11801 SOUTH FWY

City:

BURLESON

State:

Texas

Postal Code:

76028

Job Description:

***Monday-Friday 930a-6p***

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]

Work Experience:

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

Licenses and Certifications:

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

Physical Requirements:

(Please click the link below to view work requirements)

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

Pay Range:

$17.16 - $27.45

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