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DescriptionConsumer Access Specialist Part Time Days – AdventHealth GordonAll the benefits and perks you need for you and your family:Benefits from Day One for part time and full time
Paid Days Off from Day One for part time and full time
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: part time days, 30 hours/wkLocation: 1035 Red Bud Road, Calhoun, GA 30701The 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:Insurance Verification/Authorization: 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 edits Meets or exceeds accuracy standards and ensures integrity of patient accounts by working error reports as requested by leadership and entering appropriate and accurate dataQualificationsThe expertise and experiences you’ll need to succeed:Knowledge and Experience Preferred: 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/SpanishRequired Education and Experience:High School Graduate or Equivalent AND 1 year experienceEducation and Experience Preferred: One year of relevant healthcare experience Prior collections experience One year of customer service experience One year of direct Patient Access experience Associate’s degreeThis facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.Category: Patient Financial ServicesOrganization: AdventHealth GordonSchedule: 1 - DayShift: AdventHealth GordonReq ID: 22034827We 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.
