Lead Consumer Access Specialist Sebring

AdventHealth; Sebring (FL); On-site; USD 25,000 - 40,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

Paid Time Off from Day One

403-B Retirement Plan

4 Weeks Parental Leave

Job summary

AdventHealth Sebring is seeking a patient access associate to manage relationships with clinical partners and ensure smooth registration processes for patients and services.

You will verify insurance eligibility, obtain pre-authorizations, and communicate estimated costs and payment options to patients, while maintaining HIPAA compliance and exceptional customer service.

Great teamwork, attention to detail, and bilingual English/Spanish skills are valued to serve a diverse patient population.

Qualifications

• 1+ customer service experience
• 1+ revenue cycle experience
• 2+ direct patient access experience

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

Customer service

Revenue cycle

Patient access

Insurance verification

Pre-authorizations

HIPAA compliance

Education

Associate degree preferred

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

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

4200 SUN N LAKE BLVD

City

SEBRING

State

Florida

Postal Code

33872

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
• 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]

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

$18.20 - $29.12

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.