Consumer Access Specialist Lead
About the role
Manages relationships with clinical partners to ensure open communication between clinical, ancillary, and consumer access departments.
Provides timely and continual coverage of assigned work areas to offer prompt patient service and availability for all clinical partner registration needs.
Provides on-call support as needed.
Contacts insurance companies to verify insurance eligibility and benefits, and determine coverage before scheduled appointments and during or after care for unscheduled patients.
Obtains pre-authorizations from third-party payers and accurately enters required authorization information in the system.
Registers patients for all services by obtaining critical demographic elements and ensuring accuracy.
Performs Medicare compliance reviews, eligibility checks, and completes Medicare Secondary Payer Questionnaires.
Safeguards patient accounts by ensuring they are assigned the appropriate payor plans and updating financial assessments, eligibility, and benefits.
Creates accurate estimates to maximize up-front cash collections and advises patients of expected costs, collecting payments or making appropriate payment agreements.
Affords on-call support to the department supervisor with quality audits, mentoring staff, assisting with departmental training, and staff schedules.
Collaborates with case management staff as necessary and ensures patients have logistical information necessary to receive their services.
Documents all conversations with patients and insurance representatives in the appropriate fields.
Actively attends department meetings and promotes positive dialogue within the team.
Responsibilities
- Manages relationships with clinical partners
- Ensures timely coverage of assigned work areas
- Provides on-call support
- Verifies insurance eligibility and benefits
- Obtains pre-authorizations
- Registers patients for all services
- Performs Medicare compliance reviews
- Safeguards patient accounts
- Creates accurate estimates
- Attends department meetings
Requirements
- Associate's degree in business or related field preferred
- High school diploma or equivalent required
- 1+ years of customer service experience
- 1+ years of revenue cycle experience
- 2+ years of direct patient access experience preferred
- CHAA certification preferred
- CRCR certification preferred
- Mature judgement in dealing with patients, physicians, and insurance representatives
- Intermediate knowledge of Microsoft programs and familiarity with database programs
- Ability to operate general office machines
- Ability to learn and perform multiple tasks
- Ability to communicate professionally and effectively
- 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
- Understands HIPAA privacy rules and uses discretion when discussing patient-related information
- Basic medical terminology
- Advanced understanding of insurance knowledge and benefits
- Advanced understanding of hospital electronic medical record (EMR) system
- Intermediate medical terminology
- Bilingual in English and Spanish preferred
Qualifications
- Mature judgement in dealing with patients, physicians, and insurance representatives
- Intermediate knowledge of Microsoft programs and familiarity with database programs
- Ability to operate general office machines
- Ability to learn and perform multiple tasks
- Ability to communicate professionally and effectively
- 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
- Understands HIPAA privacy rules and uses discretion when discussing patient-related information
- Basic medical terminology
- Advanced understanding of insurance knowledge and benefits
- Advanced understanding of hospital electronic medical record (EMR) system
- Intermediate medical terminology
- Bilingual in English and Spanish preferred
Skills
- Mature judgement in dealing with patients, physicians, and insurance representatives
- Intermediate knowledge of Microsoft programs and familiarity with database programs
- Ability to operate general office machines
- Ability to learn and perform multiple tasks
- Ability to communicate professionally and effectively
- 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
- Understands HIPAA privacy rules and uses discretion when discussing patient-related information
- Basic medical terminology
- Advanced understanding of insurance knowledge and benefits
- Advanced understanding of hospital electronic medical record (EMR) system
- Intermediate medical terminology
- Bilingual in English and Spanish preferred
Benefits
Extensive benefits package including medical, dental, vision insurance, life insurance, disability insurance, paid time off, retirement plan, and more.
Pay
$18.69 - $29.89 per hour
Schedule
Full-time, Day shift