Patient Access & Benefits Specialist

adventhealth

La Grange (IL)

On-site

USD 27,552 - 44,083

Full time

14 days+

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Benefits offered by this job

Benefits from Day One: Medical, Dental

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

Job summary

AdventHealth in Greenwood Village, CO is seeking a Patient Access/Revenue Cycle professional to perform Medicare compliance reviews, verify insurance benefits, and register patients for services. The role requires strong communication, attention to detail, and adherence to HIPAA and CMS guidelines.

The position emphasizes accurate billing, pre-authorizations, and collaboration across departments to enhance the patient experience.

Qualifications

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
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

Responsibilities

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.