Consumer Access Specialist PRN Se

Responsibilities

• 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 time frames.
• 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.

• 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.

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

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

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

Physical requirements apply. Please refer to external link for details.

Pay Range: $16.04 - $25.67

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