Consumer Access Specialist

Job Description

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.

Collaborates 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.

Knowledge, Skills, And Abilities

• 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
• Ability to adapt in ever-changing healthcare environment
• Follows 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

Education

High School Grad or Equiv [Required]

Physical Requirements

Click here to view work requirements

Schedule/Shift

Remote: typically M-F 7a-3:30p, however, may be required to work occasional weekends if needed.

Pay Range

$16.63 - $26.60

Background Screening Requirement

Certain positions are subject to Florida Level 2 background screening, including fingerprinting, as required by state law.

Equal Opportunity Employer

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.