Consumer Access Specialist Patient Access FT Day Winter Garden

DescriptionYOU ARE REQUIRED TO SUBMIT A RESUME WITH YOUR APPLICATION!Consumer Access Specialist - AdventHealth - Winter GardenLocation Address: 2000 Fowler Grove Blvd, Winter Garden, FL 34787Top Reasons to work at AdventHealth - Winter GardenAdventHealth Winter Garden is a state-of-the-art emergency facility featuring board-certified physicians trained in the care of both adults and children

The 97,415-square-foot, three-story facility opened in February 2016 across from Winter Garden Village at Fowler Groves

It is AdventHealth’s ninth campus in Central Florida. Outpatient imaging, lab, and surgical services, as well as primary care and specialty physician offices, are all available at one convenient location

Work Hours/Shift: Full Time Day (Friday to Sunday 9a-9p )You Will Be Responsible For:Proactively contacts insurance companies by phone, fax, online portal, and other resources to obtain and verify insurance eligibility and benefits and determine extent of coverage within established timeframe before scheduled appointments and during or after care for unscheduled patients

Meet department standard when obtaining pre-authorizations from third-party payers in accordance with payer requirements and within established timeframe before scheduled appointments and during or after care for unscheduled patients. Accurately enters required authorization information in AdventHealth systems to include length of authorization, total number of visits, and/or units of medication

Maintain close working relationship with clinical partners and physician offices to resolve issues with obtaining pre-authorizations. Conducts diligent follow-up on missing or incomplete pre-authorizations with third-party payers to minimize authorization related denials through phone calls, emails, faxes, and payer websites, updating documentation as needed

Minimizes duplication of medical records by using problem-solving skills to verify patient identity through demographic details

Ensures patient accounts are assigned the appropriate payor plans

Ensures all financial assessments, eligibility, and benefits are updated and thorough to support post care financial needs. Uses utmost caution that obtained benefits, authorizations, and pre-certifications are correct and as accurate as possible to avoid rejections and/or denials. Maintains a current and thorough knowledge of utilizing online eligibility pre-certification tools made available

Thoroughly documents all conversations with patients and insurance representatives - including payer decisions, collection attempts, and payment plan arrangements

Coordinates with case management staff as necessary (e.g., when pre-authorization cannot be obtained for an inpatient stay)

Adheres to HIPAA regulations by verifying information to determine caller authorization level receiving information on account.

Creates accurate estimates to maximize up-front cash collections and adds collections documentation where required

Calculates patients’ co-pays, deductibles, and co-insurance. Provides personalized estimates of patient financial responsibility based on their insurance coverage or eligibility for government programs prior to service for both inpatient and outpatient services

QualificationsWhat You Will Need:Required:One year of customer service experience

High School diploma or GED

Preferred:One year of relevant healthcare experience

One year of customer service experience

Prior collections experience

Associate degree

GENERAL SUMMARY:Ensures patients are appropriately financially cleared for all appointments. Performs eligibility verification, obtains pre-cert and/or authorizations, clears registration errors and edits pre-bill, and performs other duties as required. Maintains a close working relationship with clinical partners to ensure continual open communication between clinical, ancillary and patient access departments. Actively participates in extending exemplary service to both internal and external customers and accepts responsibility in maintaining relationships that are equally respectful to all.Job Keywords: Registration Representative, Authorization Representative, Patient Registration, PreAccess, MaitlandThis facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.Category: Patient Financial ServicesOrganization: AdventHealth Winter GardenSchedule: Full-timeShift: 1 - DayTravel: AdventHealth Winter GardenReq ID: 21040434We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.