AdventHealth
Consumer Access Radiology Oncology
AdventHealth, Orlando, Florida, us, 32885
All the benefits and perks you need for you and your family:Benefits from Day OnePaid Days Off from Day OneStudent Loan Repayment ProgramCareer DevelopmentWhole Person Wellbeing ResourcesMental Health Resources and SupportPet Insurance*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:
PRNShift:
Flex ScheduleLocation:
400 CELEBRATION PLACE, Celebration, 34747Faith-based & mission-driven organizationCentral Florida’s premier multi-specialty medical groupComprehensive Employee Benefits such as Educational ReimbursementCREATION Health employee wellness and lifestyle programsPositive working climate to support a work-life balanceThe role you’ll contribute:Ensures patients are appropriately financially cleared for all appointments. Performs eligibility verification, obtains pre-cert and/or authorizations, clears registration errors and edits pre-bill, and performs 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.The value you’ll bring to the team:Proactively contacts insurance companies by phone, fax, online portal, and other resources to obtain and verify insurance eligibility and benefits and determine the extent of coverage within established timeframe before scheduled appointments and during or after care for unscheduled patients.Meets department standards when obtaining 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.Maintains a close working relationship with clinical partners and physician offices to resolve 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.Minimizes duplication of medical records by using problem-solving skills to verify patient identity through demographic details.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.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).Adheres to HIPAA regulations by verifying information to determine caller authorization level receiving information on account.Creates accurate estimates to maximize up-front cash collections and adds collections documentation where required.Calculates patients’ co-pays, deductibles, and co-insurance. Provides personalized estimates of patient financial responsibility based on their insurance coverage or eligibility for government programs prior to service for both inpatient and outpatient services.KNOWLEDGE AND SKILLS REQUIRED:· Ability to use discretion when discussing personnel and patient-related issues that are confidential in nature.· Responsive to the ever-changing matrix of hospital needs and acts accordingly.· Self-motivator, multitasker, prioritizes duties, pays attention to detail, and responsive to the needs of the department.· Proficient in Microsoft Office Programs such as Outlook, Word, and Excel.· Proficiency in performance of basic math functions, capability of communicating professionally and effectively in English, both verbally and in writing.KNOWLEDGE AND SKILLS PREFERRED:· Bi-lingual (English required and Spanish preferred), both written and verbal communication.· Knowledge of Electronic Health Records (EHR).· Experience working with and obtaining insurance authorizations.· Read and understand medical terminology.EDUCATION AND EXPERIENCE REQUIRED:· One (1) year experience in Patient Financial Services, Patient Access, Customer Service, or related area (registration, finance, collections, customer service, medical office, or contract management).EDUCATION AND EXPERIENCE PREFERRED:· Associate degree and/or higher-level education or completed coursework.· Two (2) years’ experience in Oncology related business operations within specialty pharmacy, insurance verification, payor reimbursement guidelines, and/or authorization submission. Familiarity with medical terminology and concepts. Working knowledge with third party insurance administrators’ authorization and clinical care processes.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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together
we are even better.Schedule:
PRNShift:
Flex ScheduleLocation:
400 CELEBRATION PLACE, Celebration, 34747Faith-based & mission-driven organizationCentral Florida’s premier multi-specialty medical groupComprehensive Employee Benefits such as Educational ReimbursementCREATION Health employee wellness and lifestyle programsPositive working climate to support a work-life balanceThe role you’ll contribute:Ensures patients are appropriately financially cleared for all appointments. Performs eligibility verification, obtains pre-cert and/or authorizations, clears registration errors and edits pre-bill, and performs 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.The value you’ll bring to the team:Proactively contacts insurance companies by phone, fax, online portal, and other resources to obtain and verify insurance eligibility and benefits and determine the extent of coverage within established timeframe before scheduled appointments and during or after care for unscheduled patients.Meets department standards when obtaining 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.Maintains a close working relationship with clinical partners and physician offices to resolve 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.Minimizes duplication of medical records by using problem-solving skills to verify patient identity through demographic details.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.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).Adheres to HIPAA regulations by verifying information to determine caller authorization level receiving information on account.Creates accurate estimates to maximize up-front cash collections and adds collections documentation where required.Calculates patients’ co-pays, deductibles, and co-insurance. Provides personalized estimates of patient financial responsibility based on their insurance coverage or eligibility for government programs prior to service for both inpatient and outpatient services.KNOWLEDGE AND SKILLS REQUIRED:· Ability to use discretion when discussing personnel and patient-related issues that are confidential in nature.· Responsive to the ever-changing matrix of hospital needs and acts accordingly.· Self-motivator, multitasker, prioritizes duties, pays attention to detail, and responsive to the needs of the department.· Proficient in Microsoft Office Programs such as Outlook, Word, and Excel.· Proficiency in performance of basic math functions, capability of communicating professionally and effectively in English, both verbally and in writing.KNOWLEDGE AND SKILLS PREFERRED:· Bi-lingual (English required and Spanish preferred), both written and verbal communication.· Knowledge of Electronic Health Records (EHR).· Experience working with and obtaining insurance authorizations.· Read and understand medical terminology.EDUCATION AND EXPERIENCE REQUIRED:· One (1) year experience in Patient Financial Services, Patient Access, Customer Service, or related area (registration, finance, collections, customer service, medical office, or contract management).EDUCATION AND EXPERIENCE PREFERRED:· Associate degree and/or higher-level education or completed coursework.· Two (2) years’ experience in Oncology related business operations within specialty pharmacy, insurance verification, payor reimbursement guidelines, and/or authorization submission. Familiarity with medical terminology and concepts. Working knowledge with third party insurance administrators’ authorization and clinical care processes.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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