Consumer Access Specialist

Job Description

Friday and Saturday Overnights
11p-7:30am

Responsibilities

• Performs Medicare compliance reviews and issues Advance Beneficiary Notices of Noncoverage as needed.
• Creates accurate estimates for patient financial responsibility and collects payments or establishes payment plans.
• Coincides with utilization management staff for pre-authorization issues and ensures patients have necessary logistical information.
• Contacts insurance companies to verify eligibility and benefits, and obtains pre-authorizations within established timeframes.
• Registers patients for all services, ensuring accuracy and minimizing duplication of medical records.
• Collects critical demographic information from patients and confirms insurance details.
• Provides timely and continual coverage of assigned work areas during scheduled shifts, arranging relief coverage as needed.
• Manages communication between clinical, ancillary, and consumer access departments to enhance the patient experience.
• Consistently provides excellent customer service, documenting all patient and insurance representative conversations, including payer decisions and payment arrangements.
• Attends department meetings and promotes positive dialogue within the team.
• Provides coverage for PBX (Switchboard) as needed, including answering phones and transferring calls.
• Performs cashiering functions such as collections and cash reconciliation accurately.
• Other duties as assigned.

Requirements

• 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, and scanner
• Ability to effectively learn and perform multiple tasks, and organize work in a systematic and efficient fashion
• Ability to communicate professionally and effectively, both verbally and Written
• To adapt in ever-changing healthcare environment
• To follow complex instructions and procedures, with a close attention to detail
• Adheres to government guidelines such as CMS, EMTALA, and HIPAA and corporate policies
• 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/Spanish
• Experience in Customer Service related field
• Exceptional customer service skills
• Advanced understanding of insurance knowledge and benefits
• Advanced understanding of hospital electronic medical report (EMR) system
• Intermediate medical terminology

Qualifications

• High School Grad or Equiv

Physical Requirements

View physical requirements

Pay Range

$16.63 - $26.60

Background Screening Requirement

(Florida Law)
Certain positions are subject to Florida Level 2 background screening, including fingerprinting, as required by state law. Applicants may review general information about Florida’s background screening requirements at the Florida Care Provider Background Screening Clearinghouse: https://info.flclearinghouse.com/.
This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.