Consumer Access Spec PRN

Lake Placid, Florida, Description All the benefits and perks you need for you and your family: Career Development Whole Person Wellbeing Resources Mental Health Resources and Support 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. Schedule:   PRN Shift :  Days Location: 1210 US HIGHWAY 27 N, Lake Placid, 33852 The community you’ll be caring for: AdventHealth Lake Placid Immediate Health Insurance Coverage Sign on Bonus Great benefits such as: Educational Reimbursement Career growth and advancement potential Local arts scene from museums and theaters to festivals and galleries Local restaurants with the authentic taste of Florida Near 100+ clear, freshwater lakes. Ideal for swimming, boating and fishing Beautiful agriculture and farmland Nature and hiking trails The role you’ll contribute: Ensures patients are appropriately registered for all service lines. Performs eligibility verification, obtains pre-cert and/or authorizations, makes financial arrangements, requests and receives payments for services, performs cashiering functions, clears registration errors and edits pre-bill, and 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.

Provides PBX (switchboard) coverage and support as needed. The value you’ll bring to the team: 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 Verifies medical necessity in accordance with Centers for Medicare & Medicaid Services (CMS) standards and communicates relevant coverage/eligibility information to the patient. Alerts physician offices to issues with verifying insurance Obtains 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 Obtains PCP referrals when applicable Alerts physician offices to 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 Submits notice of admissions when requested by facility Corrects demographic, insurance, or authorization related errors and pre-bill edit Qualifications The expertise and experiences you’ll need to succeed: High School Diploma or equivalent 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 Ability to effectively learn and perform multiple tasks, and organize work in a systematic and efficient fashion 2/28/22   This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

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