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  • Consumer Access Specialist

    AdventHealth (Manchester, KY)



    Apply Now

    All the benefits and perks you need for you and your family:

    - Benefits from Day One

     

    - Paid Days Off from Day One

     

    - Student Loan Repayment Program

     

    - Career Development

     

    - Whole Person Wellbeing Resources

    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:** Full Time

    **Shift** : Wednesday 7a-7p, Friday and Saturday 7p-7a.

    **Location:** 210 Marie Langdon Drive, Manchester, KY 40962

    **The community you’ll be caring for:** _AdventHealth Manchester_

    • Surrounded by beautiful forests and wildlife

    • Known as “The Gateway To The Redbud Capital of Kentucky”

    • Enjoy 3,150 acres of off-roading trails

    • Home to the historical swinging bridges of Clay County

    • Rich Appalachian history and culture

    • Declared “Elk Capital of the East”

    • Over 600 miles of trails provided by the Daniel Boone National Forest

    JOB SUMMARY

    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 role you’ll contribute:

    Proactively seeks assistance to improve any responsibilities assigned to their role

     

    Accountable for maintaining a working relationship with clinical partners to ensure open

     

    communications between clinical, ancillary, and patient access departments, which enhances the

    patient experience

    Provides timely and continual coverage of assigned work area in order to offer prompt patient service

     

    and availability for all clinical partner registration needs. Arranges relief coverage during extended

     

    time away from assigned registration area

     

    Meets and exceeds productivity standards determined by department leadership

     

    Meets attendance and punctuality requirements. Maintains schedule flexibility to meet department

     

    needs. Exhibits effective time management skills by monitoring time and attendance to limit use of

     

    unauthorized overtime

     

    If applicable to facility, provides coverage for PBX (Switchboard) as needed, which includes: full

     

    shifts, breaks, and any scheduled/ unscheduled coverage requirements

     

    If applicable to facility, maintains knowledge of PBX (Switchboard), which includes: answering

     

    phones, transferring calls or providing alternative direction to the caller, paging overhead codes, and

     

    communicating effectively with clinical areas to ensure code coverage. If applicable to facility,

     

    knowledge of alarm systems and protocols and expedites code phone response. Maintains knowledge

     

    of security protocol

     

    Actively attends department meetings and promotes positive dialogue within 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 data

    Patient Data Collection:

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

     

    through demographic details

     

    Registers patients for all services (i.e. emergency room, outpatient, inpatient, observation, same day

     

    surgery, outpatient in a bed, etc.) and achieves the department specific goal for accuracy

     

    Responsible for registering patients by obtaining critical demographic elements from patients (e.g.,

     

    name, date of birth, etc.)

     

    Confirms whether patients are insured and, if so, gathers details (e.g., insurer name, plan subscriber)

     

    Performs Medicare compliance review on all applicable Medicare accounts in order to determine

     

    coverage. Identifies patients who may need Medicare Advance Beneficiary Notices of Noncoverage

     

    (ABNs). Issues ABN forms as needed

     

    Performs eligibility check on all Medicare inpatients to determine HMO status and available days.

     

    Communicates any outstanding issues with Financial Counselors and/or case management staff

     

    Completes Medicare Secondary Payer Questionnaire for Medicare beneficiaries

     

    Properly identifies patients, ensures armband accuracy, inputs demographics information, and secures

     

    the required forms to ensure compliance with regulatory policies

     

    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

     

    Delivers excellent customer service by contacting patients to inform them of authorization delays 48

     

    hours prior to their date of service and answers all questions and concerns patients may have

     

    regarding authorization status

     

    Ensures consistent monitoring of interdepartmental tracking tools to proactively identify patients that

     

    require registration to be completed.

     

    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)

     

    Ensures patients have logistical information necessary to receive their services (e.g., appointment and

     

    time, directions to facility)

    Payment Management:

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

    where required

    Calculates patients’ co-pays, deductibles, and co-insurance. Provides patients with personalized

     

    estimates of their financial responsibility based on their insurance coverage or eligibility for

     

    government programs prior to service for both inpatient and outpatient services

     

    Advises patients of expected costs and collects payments or makes appropriate payment agreements

     

    in adherence to the AdventHealth TOS Collection Policy

     

    Attempts to collect patient cost-sharing amounts (e.g., co-pays, deductibles) and outstanding balances

     

    before service. Establishes payment plan arrangements for patients per established AdventHealth

     

    policy; clearly communicates due dates and amount of each installment. Collects payment plan

     

    installments, out-of-pocket costs, outstanding previous balances, and any other applicable amount

     

    from patients per policy. Informs patients of any convenient payment options (e.g., portal, mobile

     

    apps) and follows deferral procedure as required

     

    Connects patients with financial counseling or Medicaid eligibility vendor as appropriate

     

    Contacts patient to advise them of possible financial responsibility and connects them with a financial

     

    counselor if necessary

     

    Performs cashiering functions such as collections and cash reconciliation with accuracy in support of

     

    the pre-established legal and financial guidelines of AdventHealth when required

     

    Discusses financial arrangements for newborn(s), informs patient of the timeframe for enrolling a

     

    newborn in coverage, provides any documentation or guidance for the patient to enroll their child

     

    prior to or after the anticipated delivery date, and communicates appropriate information to

     

    registration staff as needed

    Qualifications

    Required Education:

    + High School Diploma

     

    This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. The salary range reflects the anticipated base pay range for this position. Individual compensation is determined based on skills, experience and other relevant factors within this pay range. The minimums and maximums for each position may vary based on geographical location.

     

    **Category:** Patient Financial Services

    **Organization:** AdventHealth Manchester

    **Schedule:** Full-time

    **Shift:** 3 - Night

    **Req ID:** 25023828

     

    We 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.

     


    Apply Now



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