Consumer Access Specialist - ED Weekday Days

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.
Contact 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.
Manages communication between clinical, ancillary, and consumer access departments to enhance the patient experience.
Provides timely and continual coverage of assigned work areas during scheduled shifts, arranging relief coverage as needed.
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.

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
• Exceptional customer service skills
• Advanced understanding of insurance knowledge and benefits
• Advanced understanding of hospital electronic medical report (EMR) system
• Intermediate medical terminology

Education

• Associate [Preferred]
• High School Grad or Equiv [Required]
• Field Of Study N/A

Work Experience

• 1+ customer service [Preferred]
• 1+ relevant healthcare [Preferred]
• 1+ revenue cycle [Preferred]

Additional Information

• N/A

Licenses And Certifications

• Certified Healthcare Access Associate (CHAA) [Preferred]
• Certified Revenue Cycle Rep (CRCR) [Preferred]

Physical Requirements

View physical requirements

Pay Range

$15.96 - $25.53