Consumer Access Specialist

1103 Team Member Services; Redmond (OR); On-site; USD 22,000 - 36,000; Full time

Benefits offered by this job

Medical

Dental

Vision Insurance

Life Insurance

Disability Insurance

PTO from Day One

401(k)/403(b)

Parental Leave

Career Development

Well-being Resources

Mental Health Resources

Pet Benefits

Job summary

AdventHealth is seeking a patient access/revenue cycle professional to support Medicare compliance reviews and accurate financial obligations for patients. The role requires coordinating with utilization management for pre-authorizations and ensuring patients have necessary information for services.

Primary duties include registering patients, verifying insurance, collecting payments, and maintaining timely coverage while delivering exceptional customer service.

Qualifications

• Experience in customer service within healthcare preferred.
• Knowledge of CMS, EMTALA, and HIPAA requirements.
• Ability to communicate professionally, both verbally and in writing.

Responsibilities

• Performs Medicare compliance reviews and issues ABNs as needed.
• Creates estimates for patient financial responsibility and collects payments or sets up plans.
• Coordinates with utilization management for pre-authorization and ensures patients have logistics info.
• Contacts insurers to verify eligibility/benefits and obtain pre-authorizations.
• Registers patients accurately and minimizes duplicate medical records.
• Maintains timely coverage of assigned work areas during shifts and arranges relief.
• Communicates between clinical, ancillary and access departments to improve patient experience.
• Provides excellent customer service and documents conversations with payers.

Skills

Customer service

HIPAA knowledge

Communication skills

Bilingual English/Spanish

Education

Associate degree

High school diploma

Tools

EMR system

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.

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: 501 REDMOND RD NW City: ROME State: Georgia Postal Code: 30165

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
• 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:

Physical Requirements: (Please click the link below to view work requirements) Physical Requirements - https://tinyurl.com/23km2677

Pay Range:

$16.05 - $25.67

Equal Opportunity Employer:

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.