Consumer Access Specialist Virtual

**All the benefits and perks you need for you and your family:** - **Benefits & Paid Days Off from Day One** **-** **Whole Person Wellbeing Resources** **-** **Career Growth** **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. **Shift** : FT Virtual **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:** · 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 · 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 · 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 · 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 Uses utmost caution that obtained benefits, authorizations, and pre-certifications are correct and as accurate as possible to avoid rejections and/or denials. Qualifications **The expertise and experiences you’ll need to succeed** **:** · One year of relevant healthcare experience · One year of customer service experience · Prior collections experience · High School diploma or GED **Knowledge and skills preferred:** · One year of direct Patient Access experience · Associate's degree 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 Daytona Beach **Schedule:** Full-time **Shift:** 1 - Day **Req ID:** 24041464 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.