Patient Access & Insurance Specialist (PRN)

AdventHealth; Mansfield (TX); On-site; USD 24,000 - 38,000; Part time

Job summary

AdventHealth Mansfield is seeking a PRN Revenue Cycle/Access Specialist to perform Medicare compliance reviews and establish patient financial responsibilities. You will coordinate with utilization management for pre-authorizations, verify insurance details, and ensure accurate patient registration across services.

Responsibilities include managing communications between clinical and billing teams, documenting payer conversations, and providing excellent customer service.

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
• 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

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.

Skills

Mature judgement

MS Office

Database familiarity

Office machines

Multitasking

Professional communication

Healthcare adaptability

Attention to detail

HIPAA CMS knowledge

HIPAA privacy rules

EMR systems knowledge

Medical terminology

Insurance benefits understanding

Bilingual English/Spanish

Customer service experience

Education

Associate [Preferred]

High School Grad or Equiv [Required]

Tools

None

Job description

AdventHealth Mansfield is seeking a PRN Revenue Cycle/Access Specialist to perform Medicare compliance reviews and establish patient financial responsibilities. You will coordinate with utilization management for pre-authorizations, verify insurance details, and ensure accurate patient registration across services.

Responsibilities include managing communications between clinical and billing teams, documenting payer conversations, and providing excellent customer service.