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

·    Benefits from Day One for FT/PT positions

·    Paid Days Off from Day One for FT/PT positions

·    Student Loan Repayment Program for FT/PT positions

·    Career Development

·    Whole Person Wellbeing Resources

·    Mental Health Resources and Support

·    Debt-free Education (Certifications and Degrees without out-of-pocket tuition expense)

 

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, 40 hours/week  

Shift:   Monday – Friday 6:00am – 2:30pm w/every 5^th weekend on call rotation required

Location: AdventHealth Bolingbrook Emergency Department

 

The role you’ll contribute:

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. Works complex accounts and manages escalations from Consumer Access Representatives and Consumer Access Specialists. Assists with departmental training and quality audits. Maintains a close working relationship with clinical partners to ensure continual open communication between clinical, ancillary and patient access departments. Anticipates and responds to the inquires and needs of clinical partners. 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. Ensures team success in active mentoring and meeting the stated monthly collection and accuracy goals. Monitors team performance. Carries out implementation of supervisor/manager directive.

  

The value you’ll bring to the team:

 SUPERVISORY RESPONSIBILITIES:

Helps management with training and supervising Consumer Access Representative, Consumer Access Specialist, and Senior Consumer Access Specialist in daily activities

 

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

 

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

 

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;

 

Quality Audits and Other Leadership Duties:

•Assists department supervisor with quality audits as needed

•Acts as a liaison to various departments as a knowledge leader

•Works complex accounts and manages escalations from Consumer Access Representatives and Consumer Access Specialists

•Assists with Human Resource functions, including evaluation, scheduling, and productivity •Communicates educational needs for improvement on performance, processes, and workflows to leadership via email, one-on-one, and/or team meetings

•Leads monthly team meetings and team huddles

 

KNOWLEDGE AND EXPERIENCE STRONGLY PREFERRED:

•Mature judgement in dealing with patients, physicians, and insurance representatives

•Ability to communicate professionally and effectively, both verbally and written

•Ability to follow complex instructions and procedures, with a close attention to detail

•Adheres to government guidelines such as CMS, EMTALA, and HIPAA and AdventHealth corporate policies

•Advanced understanding of insurance knowledge and benefits

KNOWLEDGE AND EXPERIENCE PREFERRED:

•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

EDUCATION AND EXPERIENCE REQUIRED:

·       High School Grad or Equiv and 1 years experience

EDUCATION AND EXPERIENCE PREFERRED: 

•Two years of direct Patient Access experience

•Associate's degree in Health Services or completed coursework related to Health Services

LICENSURE, CERTIFICATION OR REGISTRATION PREFERRED:

•Certified Healthcare Access Associate (CHAA) •Certified Revenue Cycle Representative (CRCR)

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. The salary range reflects the anticipated base pay range for this position. Individual compensation is determined based on skills, experience and other relevant factors within this pay range. The minimums and maximums for each position may vary based on geographical location.

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