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Nashville, Tennessee
Posted: 31-Jan-25
Location: Tarpon Springs, Florida
Categories:
Internal Number: 25004099
All the benefits and perks you need for you and your family:
·Paid Days Off from Day One
·Student Loan Repayment Program
· Career Development
· Whole Person Wellbeing Resources
· Mental Health Resources and Support
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 thattogetherwe are even better.
Schedule: Full time
Shift:Days
The community you’ll be caring for:AdventHealth North Pinellas
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:
· 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
· Performs other duties as assigned 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
The expertise and experiences you’ll need to succeed:
· High School Grad or Equiv and 1 years experience
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.
