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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

+ Mental Health Resources and Support

+ Pet Insurance*

+ Debt-free Education* (Certifications and Degrees without out-of-pocket tuition expense)

Our promise to you:

Joining AdventHealth is about being part of something bigger. Its 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** : Days

The community you'll be caring for:

+ Faith based & mission driven organization

+ Central Floridas premier multi-specialty medical group

+ Comprehensive Employee Benefits such as Educational Reimbursement

+ CREATION Health employee wellness and lifestyle programs

+ Positive working climate to support a work life balance

PRINCIPAL DUTIES AND JOB RESPONSIBILITIES** **:

Accountable for day-to-day functions of assigned area, ensuring all patient accounts for the region and/or division are financially cleared in a timely manner with appropriate follow up for account completion. Stays current with payor guidelines, managed care changes to authorization practices, all relevant payor portals and their third party vendors to cascade communication to respective team members timely. Implements, supervises and monitors region wide processes related to financial clearance including eligibility and verification of benefits, pre-authorization of services, notification of admission and pre-registration call center activities to ensure complete Financial Clearance is achieved 3 to 5 days out from date of service. Works with team to ensure appropriate expectations regarding verification, pre-authorization, and collection standards

Serves as single point of contact for initial communication with service partners inclusive of medical group, managed care, ancillary and support departments and is the first stage of the escalation process to leadership. Escalates high-priority accounts with missing authorization or limited benefits to appropriate clinical personnel to determine whether rescheduling is necessary. Audits performance and provides education to front line staff in order to maintain or exceed accuracy level standards. Provides constructive feedback that motivates the team and enhances knowledge to assist in meeting accuracy standard goals, minimize department registration errors, rejections, and avoidable denials. Specifically audits and ensures direct reports obtain authorization approval dates, CPT Codes, determine if procedure is considered cosmetic and verifies any other items used for procedures to aide in reduction of avoidable denials and write offs. Ensures appropriate communication is maintained with physicians, Consumer Access support staff, scheduling, third party payors, payor provider reps, managed care, contract management, patients and their guarantors to assist with optimizing appropriate financial clearance, timely access to care, appropriate billing of services, maximum revenue collection and high customer satisfaction. Collaborates closely with key stakeholders in Consumer Access, including direct interaction with physicians and clinic support personnel on all financial reporting matters, operational outcomes and issues to assist with developing and maintain productive working relationships. Runs/schedules reports and/or monitors work lists and distributes to appropriate staff ensuring representatives have work needed at all times and leadership is kept apprised of issues in performance or processes in a timely manner. Call center function requirements:

o Manage and drive real-time process, including on call routing, agent skilling/attributing to maximize agent utilization.

o Manages Contact Center daily productivity, projects and workload balance to ensure that key responsibilities are processed to meet and/or exceed department goals in accordance with Service Level and Organizational Level Agreements. Communicates outcomes to team and leadership in a timely manner, providing accurate statistical records and reports.

o Proficient at reading reports generated from call center tool to identify opportunity areas related to answer rate, abandonment rate and agent utilization.

Works with Talent Acquisition for staffing needs. Oversees new hire training to successfully meet 90-day productivity standards.

Ensures team success in meeting and exceeding stated monthly KPIs to protect financial standing of AdventHealth, by holding staff accountable for individual goals set by corporate and department leadership.

Responsible for coordinating and setting up schedules for team members' training and education sessions. Monitors team time and attendance according to policy, flexing as needed and reducing costs where applicable.

Responsible for checking in with team members at a regular cadence to provide mentorship, resolve issues, and ensure performance is reviewed according to policy. Is readily available to staff and Lead in person or by phone to answer questions and resolve issues.

Responsible for addressing progressive counseling according to policy

Identifies problems proactively for expedited resolution. Initiates and assumes responsibility for new tasks independently as appropriate and as delegated Maintains skill level and knowledge by reading updates, attending training sessions and completing study materials as needed. Completes department competencies as required and ensures staff complete competencies by the due date.

Performs other duties as assigned

KNOWLEDGE AND EXPERIENCE STRONGLY PREFERRED:

KNOWLEDGE AND SKILLS REQUIRED:

Mature judgement in dealing with patients, physicians, and insurance representatives

Advanced understanding of insurance authorization and benefits knowledge

Advanced understanding of hospital electronic medical report (EMR) and telephony system along with technological aptitude to master additional programs and technologies as needed

Intermediate 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, both verbally and nonverbally, and utilizes effective listening and questioning techniques Ability to manage diverse personalities

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 AdventHealth corporate policies Exceptional customer service skills

Advanced understanding of insurance knowledge and benefits

Advanced understanding of hospital electronic medical report (EMR) system Basic medical terminology

Must be able to read, write, and speak conversational English

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

Qualifications

_KNOWLEDGE AND EXPERIENCE PREFERRED:_

Intermediate medical terminology

Bilingual English/Spanish

EDUCATION AND EXPERIENCE REQUIRED:

Associate or 2 years experience

_EDUCATION AND EXPERIENCE PREFERRED:_

EDUCATION AND EXPERIENCE PREFERRED:

Lead or supervisory experience

LICENSURE, CERTIFICATION OR REGISTRATION REQUIRED:

_LICENSURE, CERTIFICATION OR REGISTRATION PREFERRED:_

LICENSURE, CERTIFICATION OR REGISTRATION PREFERRED:

Certified Healthcare Access Associate (CHAA) - NAHAM

Certified Revenue Cycle Representative (CRCR) - HFMA

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 Orlando

**Schedule:** Full-time

**Shift:** 1 - Day

**Req ID:** 25040106

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.