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AdventHealth Consumer Access Rep FT Evenings in Hendersonville, North Carolina

Description

Consumer Access Representative AdventHealth Hendersonville

Location Address: 100 Hospital Dr, Hendersonville, NC 28792

Top Reasons to Work at AdventHealth Hendersonville

Community Involvement

Located in the beautiful mountains of Western North Carolina

Great Benefits

Co-workers that feel like family

Faith Based

Work Hours/Shift: 2pm to 10:30pm M-F

You Will Be Responsible For:

  • Proactively seeks assistance to improve any responsibilities assigned to their role

  • Accountable for maintaining a working relationship with clinical partners to ensure open communications between clinical, ancillary, and patient access departments, which enhances the patient experience

  • Monitors work queues throughout to day to ensure patient accounts are worked timely and in accordance with established service line leader expectations

  • Meets and exceeds productivity standards determined by department leadership

  • Meets attendance and punctuality requirements. Maintains schedule flexibility to meet department needs. Exhibits effective time management skills by monitoring time and attendance to limit use of unauthorized overtime

  • Actively attends department meetings and promotes positive dialogue within the team

  • 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

  • Alerts physician offices to issues with obtaining pre-authorizations. Conducts diligent follow-up on missing or incomplete pre-authorizations with third-party payers to minimize authorization related denials through phone calls, emails, faxes, and payer websites, updating documentation as needed

  • Submits notice of admissions when requested by facility

  • Corrects demographic, insurance, or authorization related errors and pre-bill edits

  • Meets or exceeds accuracy standards and ensures integrity of patient accounts by working error reports as requested by leadership and entering appropriate and accurate data

  • 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)

  • Ensures patient accounts are assigned the appropriate payor plans

  • Ensures all financial assessments, eligibility, and benefits are updated and thorough to support post care financial needs. Uses utmost caution that obtained benefits, authorizations, and pre-certifications are correct and as accurate as possible to avoid rejections and/or denials. Maintains a current and thorough knowledge of utilizing online eligibility pre-certification tools made available

  • Thoroughly documents all conversations with patients and insurance representatives - including payer decisions, collection attempts, and payment plan arrangements

  • Coordinates with case management staff as necessary (e.g., when pre-authorization cannot be obtained for an inpatient stay)

  • Creates accurate estimates to maximize up-front cash collections and adds collections documentation where required

  • Calculates patients’ co-pays, deductibles, and co-insurance. Provides personalized estimates of patient financial responsibility based on their insurance coverage or eligibility for government programs prior to service for both inpatient and outpatient services

Qualifications

What You Will Need:

  • High School diploma or GED

  • One year of relevant healthcare experience preferred

  • Prior collections experience preferred

Job Summary:

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.

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

Category: Patient Financial Services

Organization: AdventHealth Hendersonville

Schedule: Part-time

Shift: 1 - Day

Travel: Hendersonville

We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.

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