Consumer Access Specialist Virtual

Full Time
Tampa, FL
Posted
Job description
Description


All the benefits and perks you need for you and your family:

  • Benefits from Day One
  • Paid Days Off from Day One
  • Student Loan Repayment Program
  • Career Development

Our promise to you:

Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

Schedule: Full Time

Shift: Day Shift

Location: Virtual

The community you’ll be caring for: AdventHealth Tampa

  • AdventHealth Pepin Heart Institute, known across the country for its advances in cardiovascular disease prevention, diagnosis, treatment and research.
  • Surgical Pioneers – the first in Tampa with the latest robotics in spine surgery
  • Building a brand new, six story surgical and patient care tower which will ensure state of the art medical and surgical car for generations to come
  • Awarded the Get With The Guidelines – Stroke GOLD Quality Achievement Award from the American Heart Association/American Stroke Association and have been recognized as a recipient of their Target: Stroke Honor Roll for our expertise in stroke care. We have also received certification by The Joint Commission in collaboration with the American Stroke Association as a Primary Stroke Center.

The role you’ll contribute:

Ensures patients are appropriately financially cleared for all appointments. Performs eligibility verification, obtains pre-cert and/or authorizations, clears registration errors and edits pre-bill, and performs other duties as required. Maintains a close working relationship with clinical partners to ensure continual open communication between clinical, ancillary and patient access departments. Actively participates in extending exemplary service to both internal and external customers and accepts responsibility in maintaining relationships that are equally respectful to all.

The value you’ll bring to the team:

  • Actively attends department meetings and promotes positive dialogue within the team
  • Insurance Verification/Authorization:
    • Contacts insurance companies by phone, fax, online portal, and other resources to obtain and verify insurance eligibility and benefits and determine extent of coverage within established timeframe before scheduled appointments and during or after care for unscheduled patients
    • Verifies medical necessity in accordance with Centers for Medicare & Medicaid Services (CMS) standards and communicates relevant coverage/eligibility information to the patient. Alerts physician offices to issues with verifying insurance
    • Obtains pre-authorizations from third-party payers in accordance with payer requirements and within established timeframe before scheduled appointments and during or after care for unscheduled patients. Accurately enters required authorization information in AdventHealth systems to include length of authorization, total number of visits, and/or units of medication
  • Obtains PCP referrals when applicable
  • Minimizes duplication of medical records by using problem-solving skills to verify patient identity through demographic details
  • Identifies patients who may need Medicare Advance Beneficiary Notices of Noncoverage (ABNs)
Qualifications


The expertise and experiences you’ll need to succeed:

  • High School Diploma or equivalent
  • 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
  • Ability to effectively learn and perform multiple tasks, and organize work in a systematic and efficient fashion

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

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