Consumer Access Specialist

AdventHealth; Orlando (FL); On-site; USD 23,000 - 37,000; Full time

Benefits offered by this job

Benefits from Day One

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

Job summary

AdventHealth Orlando is seeking a Medicare Compliance Specialist to perform reviews, issue ABNs, and estimate patient financial responsibility. The role ensures pre-authorizations, verifies eligibility, and coordinates with utilization management to support timely patient care.

You will register patients, collect demographics, document conversations with payers, and provide excellent customer service across departments. Night shift coverage and cross-functional collaboration are required.

Qualifications

• Mature judgement in dealing with patients, physicians, and insurance representatives
• Ability to effectively learn and perform multiple tasks, and organize work in a systematic and efficient fashion
• 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

Responsibilities

• 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
• Arranges relief coverage as needed
• Manages communication between clinical, ancillary, and consumer access departments to enhance the patient experience
• Attends department meetings and promotes positive dialogue within the team
• Provides coverage for PBX as needed, including answering phones and transferring calls
• Performs cashiering functions such as collections and cash reconciliation accurately
• Other duties as assigned.

Skills

Mature judgement

MS Office

HIPAA knowledge

Verbal & written communication

Bilingual English/Spanish

Customer service

Healthcare terminology

EMR systems

Detail oriented

Education

Associate degree

High School Diploma or equivalent

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:

Night (United States of America)

Address:

601 E ROLLINS ST

City:

ORLANDO

State:

Florida

Postal Code:

32803

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]

Additional Information:

Full-Time Evening: Monday thru Thursday 8:00pm to 6:00am.

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:

$16.79 - $26.86

Background Screening Requirement (Florida Law)

Certain positions are subject to Florida Level 2 background screening, including fingerprinting, as required by state law.

Applicants may review general information about Florida’s background screening requirements at the Florida Care Provider Background Screening Clearinghouse: https://info.flclearinghouse.com/

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