Consumer Access Specialist

AdventHealth; Calhoun (GA); On-site; USD 22,000 - 35,000; Full time

Job summary

AdventHealth in Calhoun, GA is seeking a Revenue Cycle/Customer Service Associate to support Medicare compliance reviews and patient billing.

You will estimate financial responsibility, collect payments or set up payment plans, verify insurance eligibility, obtain pre-authorizations, register patients for services, and document payer decisions.

The role requires strong communication, HIPAA knowledge, bilingual English/Spanish, mature judgment, and prior healthcare customer service experience.

Qualifications

• Associate degree or equivalent preferred.
• Excellent communication and customer service skills.
• Knowledge of HIPAA and CMS guidelines.

Responsibilities

• Perform Medicare compliance reviews and issue ABNs as needed.
• Create accurate estimates for patient financial responsibility and collect payments or set up payment plans.
• Coordinate with utilization management for pre-authorizations and ensure patients have necessary information.
• Verify insurance eligibility and obtain pre-authorizations within required timeframes.
• Register patients for all services with accuracy and minimal duplication of records.
• Collect demographic information and confirm insurance details.
• Provide coverage for assigned work areas and arrange relief as needed.
• Communicate between clinical, ancillary and access departments to improve patient experience.
• Document payer conversations and decisions; maintain thorough notes.

Skills

Mature judgement

Microsoft Office

Multi-tasking

Professional communication

HIPAA knowledge

Bilingual English/Spanish

Customer service experience

Education

Associate degree

High School diploma

Tools

EMR systems

Medical terminology

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 (United States of America)

Address:

1035 RED BUD RD NE

City:

CALHOUN

State:

Georgia

Postal Code:

30701

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

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

Pay Range:

$16.05 - $25.67

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