Consumer Access Specialist

Consumer Access Specialist

Performs Medicare compliance reviews and issues Advance Beneficiary Notices of Noncoverage as needed. Creates accurate estimates for patient financial responsibility and collects payments or establishes payment plans. Coordinates with utilization management staff for pre-authorization issues and ensures patients have necessary logistical information. Contacts insurance companies to verify eligibility and benefits, and obtains pre-authorizations within established timeframes. Registers patients for all services, ensuring accuracy and minimizing duplication of medical records. Collects critical demographic information from patients and confirms insurance details. Provides timely and continual coverage of assigned work areas during scheduled shifts, arranging relief coverage as needed. Manages communication between clinical, ancillary, and consumer access departments to enhance the patient experience. Consistently provides excellent customer service, documenting all patient and insurance representative conversations, including payer decisions and payment arrangements. Attends department meetings and promotes positive dialogue within the team. Provides coverage for PBX (Switchboard) as needed, including answering phones and transferring calls. Performs cashiering functions such as collections and cash reconciliation accurately. Other duties as assigned.

Knowledge, Skills, and Abilities:

• 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 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
• 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
• Knowledge of computer programs and electronic health record programs
• Basic knowledge of medical terminology
• Exposure to insurance benefits; ability to decipher insurance benefit information
• Bilingual English/Spanish
• Experience in Customer Service related field
• Exceptional customer service skills
• Advanced understanding of insurance knowledge and benefits
• Advanced understanding of hospital electronic medical report (EMR) system
• Intermediate medical terminology

Education:

• Associate [Preferred]
• High School Grad or Equiv [Required]

Field of Study: N/A

Work Experience:

• 1+ customer service [Preferred]
• 1+ relevant healthcare [Preferred]
• 1+ revenue cycle [Preferred]

Licenses and Certifications:

• Certified Healthcare Access Associate (CHAA) [Preferred]
• Certified Revenue Cycle Rep (CRCR) [Preferred]

Physical Requirements: (Please click the link below to view work requirements) Physical Requirements

Pay Range: $19.77 $31.64

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