Consumer Access Specialist part time weekends
Company: AdventHealth
Location: Burleson
Posted on: July 22, 2021
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Job Description:
Consumer Access Specialist -
Texas Health Huguley- operated as
joint venture between Texas Health Resources and
AdventHealth Location
Address: 11801 South
Fwy., Burleson, TX 76028 Top Reasons to
Work At Texas Health Huguley, Burleson,
TX Work
Hours/Shift: Part Time
24/hrs/week Every other
weekend Saturday &
Sunday 7am -
7pm 9am -
9pm You Will Be
Responsible For: General
Duties: •
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 •
Provides timely and continual coverage of assigned work area in
order to offer prompt patient service and availability for all
clinical partner registration needs. Arranges relief coverage
during extended time away from assigned registration
area •
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 •
If applicable to facility, provides coverage for PBX (Switchboard)
as needed, which includes: full shifts, breaks, and any scheduled/
unscheduled coverage requirements •
If applicable to facility, maintains knowledge of PBX
(Switchboard), which includes: answering phones, transferring calls
or providing alternative direction to the caller, paging overhead
codes, and communicating effectively with clinical areas to ensure
code coverage. If applicable to facility, knowledge of alarm
systems and protocols and expedites code phone response. Maintains
knowledge of security protocol •
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 •
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 Patient Data
Collection: •
Minimizes duplication of medical records by using problem-solving
skills to verify patient identity through demographic
details •
Registers patients for all services (i.e. emergency room,
outpatient, inpatient, observation, same day surgery, outpatient in
a bed, etc.) and achieves the department specific goal for
accuracy •
Responsible for registering patients by obtaining critical
demographic elements from patients (e.g., name, date of birth,
etc.) •
Confirms whether patients are insured and, if so, gathers details
(e.g., insurer name, plan
subscriber) •
Performs Medicare compliance review on all applicable Medicare
accounts in order to determine coverage. Identifies patients who
may need Medicare Advance Beneficiary Notices of Noncoverage
(ABNs). Issues ABN forms as needed •
Performs eligibility check on all Medicare inpatients to determine
HMO status and available days. Communicates any outstanding issues
with Financial Counselors and/or case management
staff •
Completes Medicare Secondary Payer Questionnaire for Medicare
beneficiaries •
Properly identifies patients, ensures armband accuracy, inputs
demographics information, and secures the required forms to ensure
compliance with regulatory policies •
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 •
Delivers excellent customer service by contacting patients to
inform them of authorization delays 48 hours prior to their date of
service and answers all questions and concerns patients may have
regarding authorization status •
Ensures consistent monitoring of interdepartmental tracking tools
to proactively identify patients that require registration to be
completed. •
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) •
Ensures patients have logistical information necessary to receive
their services (e.g., appointment and time, directions to
facility) Payment
Management: •
Creates accurate estimates to maximize up-front cash collections
and adds collections documentation where
required •
Calculates patients’ co-pays, deductibles, and co-insurance.
Provides patients with personalized estimates of their financial
responsibility based on their insurance coverage or eligibility for
government programs prior to service for both inpatient and
outpatient services •
Advises patients of expected costs and collects payments or makes
appropriate payment agreements in adherence to the AdventHealth TOS
Collection Policy •
Attempts to collect patient cost-sharing amounts (e.g., co-pays,
deductibles) and outstanding balances before service. Establishes
payment plan arrangements for patients per established AdventHealth
policy; clearly communicates due dates and amount of each
installment. Collects payment plan installments, out-of-pocket
costs, outstanding previous balances, and any other applicable
amount from patients per policy. Informs patients of any convenient
payment options (e.g., portal, mobile apps) and follows deferral
procedure as required •
Connects patients with financial counseling or Medicaid eligibility
vendor as appropriate •
Contacts patient to advise them of possible financial
responsibility and connects them with a financial counselor if
necessary •
Performs cashiering functions such as collections and cash
reconciliation with accuracy in support of the pre-established
legal and financial guidelines of AdventHealth when
required •
Discusses financial arrangements for newborn(s), informs patient of
the timeframe for enrolling a newborn in coverage, provides any
documentation or guidance for the patient to enroll their child
prior to or after the anticipated delivery date, and communicates
appropriate information to registration staff as
needed What You Will
Need: Job
Summary: Ensures patients are appropriately registered for
all service lines. Performs eligibility verification, obtains
pre-cert and/or authorizations, makes financial arrangements,
requests and receives payments for services, performs cashiering
functions, clears registration errors and edits pre-bill, and 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. Provides PBX
(switchboard) coverage and support as
needed.
Description
This facility is an equal
opportunity employer and complies with federal, state and local
anti-discrimination laws, regulations and ordinances.
Keywords: AdventHealth, Dallas , Consumer Access Specialist part time weekends, Other , Burleson, Texas
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