Consumer Access Specialist

1106 Portercare Adventist Health System; Parker (SD); On-site; USD 28,000 - 44,000; Full time

Job summary

AdventHealth Parker is seeking a skilled patient access professional to perform Medicare compliance reviews, estimate patient financial responsibility, and coordinate with utilization management for pre-authorizations. You will register patients, verify insurance details, and ensure accurate data entry across the EMR system.

The role includes coordinating with multiple departments to enhance the patient experience, maintaining documentation of payer decisions, and providing coverage for

Qualifications

• Mature judgment in dealing with patients, physicians, and insurance representatives.

Responsibilities

• Performs Medicare compliance reviews and issues Advance Beneficiary Notices of Noncoverage as needed.
• Registers patients for all services, ensuring accuracy and minimizing duplication of medical records.
• Collects demographic information and confirms insurance details.
• Provides coverage of assigned work areas during shifts and arranges relief as needed.
• Communicates between clinical, ancillary, and access departments to improve patient experience.
• Completes cashiering tasks and handles payments accurately.

Skills

Customer service

Medicare knowledge

HIPAA compliance

EMR systems

Professional communication

Bilingual English/Spanish

Multitasking

Documentation

Education

Associate

High School Graduate

CHAA certification

CRCR certification

Tools

Microsoft Office

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.

Schedule: PRN Shift: Day (United States of America) Address: 9395 CROWN CREST BLVD City: PARKER State: Colorado Postal Code: 80138

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: (Please click the link below to view work 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. Every day, our fellow team members show up to work, unified by one shared mission: Extending the Healing Ministry of Jesus Christ. As a faith-based health care organization, our story is one of hope as we strive to heal and restore the body, mind and spirit. Though our facilities are spread across the country, this unwavering belief binds us together. Across every office, exam and patient room, we’re committed to providing individualized, holistic care. This is our Christian mission, and it inspires us to help make communities healthier and happier.