Sr. Consumer Access Specialist Sebring

About the role

Maintains a working relationship with clinical partners to enhance the patient experience.

Ensures timely and continual coverage of assigned work area for prompt patient service and availability.

Verifies insurance eligibility and benefits for patients.

Registers patients for all services and ensures accuracy of demographic elements.

Performs Medicare compliance reviews and updates financial assessments and eligibility.

Coordinates with case management staff for unscheduled patients.

Maintains the department invoice process and documents all interactions with patients and insurance representatives.

Responsibilities

• Maintains open communications between clinical, ancillary, and consumer access departments.
• Arranges relief coverage during extended absences.
• Contacts insurance companies to obtain and verify insurance eligibility and benefits.
• Registers patients for all services and ensures accuracy of demographic elements.
• Performs Medicare compliance reviews and updates financial assessments and eligibility.
• Creates accurate estimates to maximize up-front cash collections.
• Coordinates with case management staff as necessary.
• Maintains the department invoice process including receiving, validating, filing, and processing invoices for payment.
• Documents all conversations with patients and insurance representatives.
• Coordinates with case management staff as necessary (e.g., when pre-authorization cannot be obtained for an inpatient stay).

Requirements

• 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 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.
• Ability 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.
• Exceptional customer service skills.
• Advanced understanding of insurance knowledge and benefits.
• Advanced understanding of hospital electronic medical report (EMR) system.
• Basic medical terminology.
• Must be able to read, write, and speak conversational English.
• 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.
• Intermediate medical terminology.
• Bilingual – English/Spanish.

Qualifications

• Associate degree in business, education, Health Services Administration, or related field.
• High School Grad or Equiv.
• 1+ years of customer service experience.
• 1+ years of revenue cycle experience.
• 2+ years of direct patient access experience (preferred).

Skills

• Mature judgement in dealing with patients, physicians, and insurance representatives.
• Intermediate knowledge of Microsoft programs and database programs.
• Ability to operate general office machines.
• Effective learning and organizing work.
• Professional communication skills.
• Adaptability in healthcare environments.
• Complex instruction following and attention to detail.
• Compliance with government guidelines and corporate policies.
• Exceptional customer service skills.
• Advanced insurance knowledge and EMR system understanding.
• Basic medical terminology.
• Reading, writing, and speaking conversational English.
• HIPAA privacy rules understanding and confidentiality.
• Intermediate medical terminology.
• Bilingual – English/Spanish.

Benefits

Includes medical, dental, vision insurance, life insurance, disability insurance, paid time off, 403-B retirement plan, whole person well-being resources, mental health resources and support, pet benefits, career development, and more.

Pay

$17.01 - $27.21 per hour.

Schedule

Full time, Day shift.