Consumer Access Specialist PRN Weekend Nights

1103 Team Member Services; Florida; On-site; USD 22,000 - 34,000; Full time

Job summary

AdventHealth is seeking a PRN Patient Access/Revenue Cycle specialist for night-weekend coverage in North Carolina. You will handle Medicare compliance, insurance verifications, pre-authorizations, and patient registrations while delivering excellent customer service.

Ideal candidates have 1+ year in healthcare revenue cycle or customer service, with familiarity with EMR systems and HIPAA guidelines; bilingual English/Spanish is a plus.

Qualifications

• High School Grad or Equiv required; Associate degree preferred.
• CHAA/CRCR certifications preferred.
• 1+ year in customer service and healthcare revenue cycle preferred.
• Bilingual English/Spanish highly desirable.
• Knowledge of HIPAA privacy rules and CMS guidelines.

Responsibilities

• Performs Medicare compliance reviews and issues ABNs as needed.
• Creates estimates for patient financial responsibility and collects payments.
• Coordinates with utilization management for pre-authorizations.
• Verifies eligibility and benefits with insurers and obtains pre-authorizations.
• Registers patients and verifies insurance details to ensure accuracy.

Skills

Customer service

Healthcare terminology

HIPAA privacy

EMR systems

Bilingual English/Spanish

Education

Associate degree (Preferred)

High School diploma or equivalent (Required)

Tools

Microsoft Office

EMR systems

Database programs

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: Night-Weekend (United States of America) Address: 101 HOSPITAL DR City: COLUMBUS State: North Carolina Postal Code: 28722

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.

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]

Licenses and Certifications

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

Physical Requirements

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

Pay Range: $16.11 - $25.78

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.