Lead Consumer Access Specialist

AdventHealth; Florida; On-site; USD 26,000 - 41,000; Full time

Job summary

AdventHealth is seeking a patient access professional to manage clinical partner relationships and ensure clear communication across departments. You will verify insurance, obtain pre-authorizations, register patients, and support Medicare compliance and billing accuracy.

You will also handle on-call coverage, patient scheduling, and upfront cash estimation while mentoring staff and contributing to departmental training and continuous improvement.

Qualifications

• Mature judgement in dealing with patients, physicians, and insurance representatives
• Intermediate 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
• Exceptional customer service skills
• Advanced understanding of insurance knowledge and benefits
• Advanced understanding of hospital EMR system
• Basic medical terminology
• Must be able to read, write, and speak conversational English
• 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
• Intermediate medical terminology
• Bilingual – English/Spanish

Responsibilities

• Manages relationships with clinical partners to ensure open communication between clinical, ancillary, and consumer access departments.
• Provides timely and continual coverage of assigned work areas to offer prompt patient service and availability for all clinical partner registration needs.
• Provides on-call support as needed.
• Contacts insurance companies to verify insurance eligibility and benefits, and determine coverage before scheduled appointments and during or after care for unscheduled patients.
• Obtains pre-authorizations from third-party payers and accurately enters required authorization information in the system.
• Registers patients for all services by obtaining critical demographic elements and ensuring accuracy.
• Performs Medicare compliance reviews, eligibility checks, and completes Medicare Secondary Payer Questionnaires.
• Ensures patient accounts are assigned the appropriate payor plans and updates financial assessments, eligibility, and benefits.
• Creates accurate estimates to maximize up-front cash collections and advises patients of expected costs, collecting payments or making appropriate payment agreements.
• Assists department supervisor with quality audits, mentoring staff, assisting with departmental training, and staff schedules.
• Coordinates with case management staff as necessary and ensures patients have logistical information necessary to receive their services.
• Documents all conversations with patients and insurance representatives in the appropriate fields.
• Actively attends department meetings and promotes positive dialogue within the team.
• Other duties as assigned.

Skills

Mature judgment

MS Office

Office equipment

Multi-tasking

Professional communication

Healthcare environment

Attention to detail

HIPAA compliance

Customer service

Insurance knowledge

EMR system

Medical terminology

English proficiency

Bilingual English/Spanish

Education

Associate

High School

Tools

EMR system

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:

2000 FOWLER GROVE BLVD

City:

WINTER GARDEN

State:

Florida

Postal Code:

34787

Job Description:

Manages relationships with clinical partners to ensure open communication between clinical, ancillary, and consumer access departments. Provides timely and continual coverage of assigned work areas to offer prompt patient service and availability for all clinical partner registration needs. Provides on-call support as needed. Contacts insurance companies to verify insurance eligibility and benefits, and determine coverage before scheduled appointments and during or after care for unscheduled patients. Obtains pre-authorizations from third-party payers and accurately enters required authorization information in the system. Registers patients for all services by obtaining critical demographic elements and ensuring accuracy. Performs Medicare compliance reviews, eligibility checks, and completes Medicare Secondary Payer Questionnaires. Ensures patient accounts are assigned the appropriate payor plans and updates financial assessments, eligibility, and benefits. Creates accurate estimates to maximize up-front cash collections and advises patients of expected costs, collecting payments or making appropriate payment agreements. Assists department supervisor with quality audits, mentoring staff, assisting with departmental training, and staff schedules. Coordinates with case management staff as necessary and ensures patients have logistical information necessary to receive their services. Documents all conversations with patients and insurance representatives in the appropriate fields. Actively attends department meetings and promotes positive dialogue within the team. Other duties as assigned.

Knowledge, Skills, and Abilities:

• Mature judgement in dealing with patients, physicians, and insurance representatives
• Intermediate 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
• Exceptional customer service skills
• Advanced understanding of insurance knowledge and benefits
• Advanced understanding of hospital electronic medical report (EMR) system
• Basic medical terminology
• Must be able to read, write, and speak conversational English
• 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
• Intermediate medical terminology
• Bilingual – English/Spanish

Education:

• Associate [Preferred]
• High School Grad or Equiv [Required]

Field of Study:

• in business or related field

Work Experience:

• 1+ customer service experience [Required]
• 1+ revenue cycle experience [Required]
• 2+ direct patient access experience [Preferred]

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:

$18.87 - $30.19

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.