Adventist Health

Provide occupational therapy treatments under supervision, assist patients with mobility and daily activities, and support rehab care plan development. | Requires OTA certification, BLS certification, valid driver's license, and preferably 1-2 years of occupational therapy or rehabilitative services experience. | Job Description $5,000 INCENTIVE AVAILABLE! Our home health and hospice agencies are located throughout California, Hawaii, Oregon and Washington. They serve the entire community and offer personalized in-home care, and many have been recipients of Home Care Elite awards. So whether you're looking for the buzz of a large city, the tranquility of nearby mountain bike trails or something in between, we encourage you to explore our organization. Job Summary: Provides prescribed occupational therapy treatments under the supervision of licensed occupational therapists, including geriatric, orthopedic, neurologic, pediatric and neonatal rehabilitation as well as splint follow-ups and other medical conditions. Participates in home environmental assessments, assisting with rehab care plan development. Works under minimal supervision and may mentor and train staff on technical skills. Job Requirements: Education and Work Experience: • High School Education/GED or equivalent: Preferred • Associate's/Technical Degree in occupational therapy or equivalent combination of education/related experience: Preferred • Two years' rehabilitative services experience or equivalent education: Preferred • One year's occupational therapy experience: Preferred Licenses/Certifications: • Occupational Therapy Assistant: Required • Cardiopulmonary Resuscitation (CPR) or Basic Life Support (BLS OR HS-BLS OR RQIBLS) certification: Required • Valid Driver's License (DL) and must be at least 21 years of age or older: Required • Occupational Therapist Assistant (OTA): Required • Basic Life Support (BLS OR HS-BLS OR RQI BLS) certification: Required Essential Functions: • Implements treatment plans and selects modalities to meet established goals. • Transports, transfers, and assists patients in and out of wheelchairs, beds, tilt tables and stretchers while ensuring safety and minimizing undue patient discomfort. Assists patients with dressing and toileting needs. • Assists with inpatient and outpatient schedules, as needed. • Arranges patient schedules for scheduled visit arrivals and reports any delays. • Assists in the maintenance, care and cleaning of equipment and supplies. • Performs other job-related duties as assigned. Organizational Requirements: Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply. Adventist Health participates in E-Verify. Visit https://adventisthealth.org/careers/everify/ for more information about E-Verify. By choosing to apply, you acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices and understand the contents therein.

Manage and provide skilled nursing care to patients in their homes, including assessments, care planning, coordination, education, and documentation. | Must have RN licensure, BLS certification, valid driver's license and reliable vehicle, with preferred BSN and acute/home care experience. | Job Description $15,000 Hiring Incentive! Our home health and hospice agencies are located throughout California, Hawaii, Oregon and Washington. They serve the entire community and offer personalized in-home care, and many have been recipients of Home Care Elite awards. So whether you're looking for the buzz of a large city, the tranquility of nearby mountain bike trails or something in between, we encourage you to explore our organization. Job Summary: Plans, organizes and directs home care services to meet the needs of patients in their homes. Manages a patient caseload in an effective and efficient manner. Provides patient care independently, but also collaborates with other core disciplines in accordance with the patient's plan or care to meet care goals. Functions as a resource to patients, family members, and other care team members. Job Requirements: Education and Work Experience: • Bachelor's Degree in Nursing (BSN): Preferred • Acute care facility or home care experience: Preferred Licenses/Certifications: • Registered Nurse (RN) licensure in the state of practice: Required • Cardiopulmonary Resuscitation (CPR) or Basic Life Support (BLS OR HS-BLS OR RQIBLS) certification: Required • Valid Driver's License (DL) and must be at least 21 years of age or older: Required • Current automobile insurance and a reliable automobile: Required • Basic Life Support (BLS OR HS-BLS OR RQI BLS) certification: Required Essential Functions: • Completes initial and ongoing comprehensive assessments of the patient's needs at appropriate time points as assigned. Completes the nursing assessment of assigned patients. Demonstrates ability to discuss and/or teach pertinent aspects of nursing care and patient rights and responsibilities. Identifies and reports problems, abnormal findings, or nursing diagnoses that need follow up. • Implements plan of care in accordance with identified needs. Participates with the patient in clarifying mutually agreed upon goals and incorporates these goals into the plan of care. Provides direct and/or indirect skilled, safe, quality care. Coordinates patient care with other disciplines and integrates input from disciplines. Performs ongoing nursing assessments and changes plans of care as needed. • Accurately completes and legibly documents all pertinent information in accordance with established policies and procedures by documenting patient care delivery, patient status, patient's response to treatment, and therapeutic interventions. Ensures that all documentation is completed and submitted in a timely manner. Updates nursing plans and medication profiles when changes occur. • Counsels and educates the patient and family in meeting healthcare/nursing and related needs. Provides learning opportunities for patient and caregiver, including written material as appropriate. Initiates appropriate preventative and rehabilitative nursing procedures. • Complies with all applicable legal requirements, standards, policies and procedures including, but not limited to the code of conduct, HIPAA, and documentation standards. Demonstrates professional conduct, service excellence and commitment to the mission and values of Adventist Health. On call duties will be assigned based on location and agency operational needs. If assigned by agency leadership, incumbent is required to perform on call duties. • Performs other job-related duties as assigned. Organizational Requirements: Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply. Adventist Health participates in E-Verify. Visit https://adventisthealth.org/careers/everify/ for more information about E-Verify. By choosing to apply, you acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices and understand the contents therein.

Manage and provide skilled nursing care to patients in their homes, perform assessments, implement care plans, document patient status, and educate patients and families. | Must have RN licensure, BLS certification, valid driver's license, reliable automobile, and preferably a BSN degree with acute or home care experience. | Job Description $2500 INCENTIVE AVAILABLE! Our home health and hospice agencies are located throughout California, Hawaii, Oregon and Washington. They serve the entire community and offer personalized in-home care, and many have been recipients of Home Care Elite awards. So whether you're looking for the buzz of a large city, the tranquility of nearby mountain bike trails or something in between, we encourage you to explore our organization. Job Summary: Plans, organizes and directs home care services to meet the needs of patients in their homes. Manages a patient caseload in an effective and efficient manner. Provides patient care independently, but also collaborates with other core disciplines in accordance with the patient's plan or care to meet care goals. Functions as a resource to patients, family members, and other care team members. Job Requirements: Education and Work Experience: • Bachelor's Degree in Nursing (BSN): Preferred • Acute care facility or home care experience: Preferred Licenses/Certifications: • Registered Nurse (RN) licensure in the state of practice: Required • Cardiopulmonary Resuscitation (CPR) or Basic Life Support (BLS OR HS-BLS OR RQIBLS) certification: Required • Valid Driver's License (DL) and must be at least 21 years of age or older: Required • Current automobile insurance and a reliable automobile: Required • Basic Life Support (BLS OR HS-BLS OR RQI BLS) certification: Required Essential Functions: • Completes initial and ongoing comprehensive assessments of the patient's needs at appropriate time points as assigned. Completes the nursing assessment of assigned patients. Demonstrates ability to discuss and/or teach pertinent aspects of nursing care and patient rights and responsibilities. Identifies and reports problems, abnormal findings, or nursing diagnoses that need follow up. • Implements plan of care in accordance with identified needs. Participates with the patient in clarifying mutually agreed upon goals and incorporates these goals into the plan of care. Provides direct and/or indirect skilled, safe, quality care. Coordinates patient care with other disciplines and integrates input from disciplines. Performs ongoing nursing assessments and changes plans of care as needed. • Accurately completes and legibly documents all pertinent information in accordance with established policies and procedures by documenting patient care delivery, patient status, patient's response to treatment, and therapeutic interventions. Ensures that all documentation is completed and submitted in a timely manner. Updates nursing plans and medication profiles when changes occur. • Counsels and educates the patient and family in meeting healthcare/nursing and related needs. Provides learning opportunities for patient and caregiver, including written material as appropriate. Initiates appropriate preventative and rehabilitative nursing procedures. • Complies with all applicable legal requirements, standards, policies and procedures including, but not limited to the code of conduct, HIPAA, and documentation standards. Demonstrates professional conduct, service excellence and commitment to the mission and values of Adventist Health. On call duties will be assigned based on location and agency operational needs. If assigned by agency leadership, incumbent is required to perform on call duties. • Performs other job-related duties as assigned. Organizational Requirements: Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply. Adventist Health participates in E-Verify. Visit https://adventisthealth.org/careers/everify/ for more information about E-Verify. By choosing to apply, you acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices and understand the contents therein.

The Consumer Access Specialist ensures patients are appropriately registered for all service lines and performs eligibility verification, obtains pre-certifications, and makes financial arrangements. They maintain communication with clinical partners and provide exemplary service to both internal and external customers. | A high school diploma or equivalent is required, along with preferred qualifications including relevant healthcare experience and customer service experience. Candidates should possess mature judgment and the ability to communicate effectively while adhering to HIPAA privacy rules. | AdventHealth Corporate All the benefits and perks you need for you and your family: · Benefits from Day One · 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 that together we are even better. Shift: Per-diem Job Location: Remote The role you will 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. 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. Provides PBX (switchboard) coverage and support as needed. The value you will bring to the team: · 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 · Actively attends department meetings and promotes positive dialogue within the team 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 Patient Data Collection: · Minimizes duplication of medical records by using problem-solving skills to verify patient identity through demographic details · Registers patients for all services (i.e. emergency room, outpatient, inpatient, observation, same day surgery, outpatient in a bed, etc.) and achieves the department specific goal for accuracy · Responsible for registering patients by obtaining critical demographic elements from patients (e.g., name, date of birth, etc.) · Confirms whether patients are insured and, if so, gathers details (e.g., insurer name, plan subscriber) The expertise and experiences you’ll need to succeed: · High School Grad or Equiv Required Preferred Qualifications: · 1+ of relevant healthcare experience · Prior collections experience · 1+ of customer service experience · 1+ of direct Patient Access experience · 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 HIPPAA and AdventHealth 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

The Consumer Access Specialist ensures patients are appropriately registered for all service lines, performs eligibility verification, and manages financial arrangements. They maintain communication with clinical partners and provide exemplary service to both internal and external customers. | Candidates should have a high school diploma or equivalent and at least one year of relevant experience. Preferred qualifications include an associate degree and experience in healthcare, collections, and patient access. | All the benefits and perks you need for you and your family: · Benefits from Day One · 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 that together we are even better. Shift: Monday- Friday 8:30a-5pm est Job Location: Remote The role you will 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. 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. Provides PBX (switchboard) coverage and support as needed. The value you will bring to the team: 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 * Actively attends department meetings and promotes positive dialogue within the team 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 · Corrects demographic, insurance, or authorization related errors and pre-bill edits · Meets or exceeds accuracy standards and ensures integrity of patient accounts by working error reports as requested by leadership and entering appropriate and accurate data Patient Data Collection: Minimizes duplication of medical records by using problem-solving skills to verify patient identity through demographic details Registers patients for all services (i.e. emergency room, outpatient, inpatient, observation, same day surgery, outpatient in a bed, etc.) and achieves the department specific goal for accuracy Responsible for registering patients by obtaining critical demographic elements from patients (e.g., name, date of birth, etc.) Confirms whether patients are insured and, if so, gathers details (e.g., insurer name, plan subscriber) Performs Medicare compliance review on all applicable Medicare accounts in order to determine coverage. Identifies patients who may need Medicare Advance Beneficiary Notices of Noncoverage (ABNs). Issues ABN forms as needed Performs eligibility check on all Medicare inpatients to determine HMO status and available days. Communicates any outstanding issues with Financial Counselors and/or case management staff Completes Medicare Secondary Payer Questionnaire for Medicare beneficiaries Properly identifies patients, ensures armband accuracy, inputs demographics information, and secures the required forms to ensure compliance with regulatory policies 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 Delivers excellent customer service by contacting patients to inform them of authorization delays 48 hours prior to their date of service and answers all questions and concerns patients may have regarding authorization status Ensures consistent monitoring of interdepartmental tracking tools to proactively identify patients that require registration to be completed. 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) Ensures patients have logistical information necessary to receive their services (e.g., appointment and time, directions to facility) 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; clearly communicates due dates and amount of each installment. Collects payment plan installments, out-of-pocket costs, outstanding previous balances, and any other applicable amount from patients per policy. Informs patients of any convenient payment options (e.g., portal, mobile apps) and follows deferral procedure as required Connects patients with financial counseling or Medicaid eligibility vendor as appropriate Contacts patient to advise them of possible financial responsibility and connects them with a financial counselor if necessary Performs cashiering functions such as collections and cash reconciliation with accuracy in support of the pre-established legal and financial guidelines of AdventHealth when required Discusses financial arrangements for newborn(s), informs patient of the timeframe for enrolling a newborn in coverage, provides any documentation or guidance for the patient to enroll their child prior to or after the anticipated delivery date, and communicates appropriate information to registration staff as needed The expertise and experiences you’ll need to succeed: · High School Grad or Equiv · 1+ experience Preferred Qualifications: · Associate · 1+ of relevant healthcare experience · Prior collections experience · 1+ of customer service experience · 1+ of direct Patient Access experience · 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 HIPPAA and AdventHealth 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

The Consumer Access Specialist ensures patients are appropriately registered for all service lines and performs eligibility verification, obtains pre-certifications, and makes financial arrangements. They maintain communication with clinical partners and provide exemplary service to both internal and external customers. | A high school diploma or equivalent is required, along with preferred qualifications including relevant healthcare experience and customer service experience. Candidates should possess mature judgment and the ability to communicate effectively while adhering to HIPAA privacy rules. | AdventHealth Corporate All the benefits and perks you need for you and your family: · Benefits from Day One · 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 that together we are even better. Shift: Per-diem Job Location: Remote The role you will 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. 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. Provides PBX (switchboard) coverage and support as needed. The value you will bring to the team: · 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 · Actively attends department meetings and promotes positive dialogue within the team 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 Patient Data Collection: · Minimizes duplication of medical records by using problem-solving skills to verify patient identity through demographic details · Registers patients for all services (i.e. emergency room, outpatient, inpatient, observation, same day surgery, outpatient in a bed, etc.) and achieves the department specific goal for accuracy · Responsible for registering patients by obtaining critical demographic elements from patients (e.g., name, date of birth, etc.) · Confirms whether patients are insured and, if so, gathers details (e.g., insurer name, plan subscriber) The expertise and experiences you’ll need to succeed: · High School Grad or Equiv Required Preferred Qualifications: · 1+ of relevant healthcare experience · Prior collections experience · 1+ of customer service experience · 1+ of direct Patient Access experience · 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 HIPPAA and AdventHealth 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

The Consumer Access Specialist ensures patients are appropriately registered for all service lines and performs eligibility verification, pre-certifications, and financial arrangements. They maintain communication with clinical partners and provide exemplary service to both internal and external customers. | Candidates should have a high school diploma or equivalent and at least one year of relevant experience. Preferred qualifications include an associate degree, healthcare experience, and familiarity with insurance benefits. | All the benefits and perks you need for you and your family: · Benefits from Day One · 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 that together we are even better. Shift: Monday- Friday 8:30a-5pm est Job Location: Remote The role you will 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. 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. Provides PBX (switchboard) coverage and support as needed. The value you will bring to the team: 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 * Actively attends department meetings and promotes positive dialogue within the team 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 · Corrects demographic, insurance, or authorization related errors and pre-bill edits · Meets or exceeds accuracy standards and ensures integrity of patient accounts by working error reports as requested by leadership and entering appropriate and accurate data Patient Data Collection: Minimizes duplication of medical records by using problem-solving skills to verify patient identity through demographic details Registers patients for all services (i.e. emergency room, outpatient, inpatient, observation, same day surgery, outpatient in a bed, etc.) and achieves the department specific goal for accuracy Responsible for registering patients by obtaining critical demographic elements from patients (e.g., name, date of birth, etc.) Confirms whether patients are insured and, if so, gathers details (e.g., insurer name, plan subscriber) Performs Medicare compliance review on all applicable Medicare accounts in order to determine coverage. Identifies patients who may need Medicare Advance Beneficiary Notices of Noncoverage (ABNs). Issues ABN forms as needed Performs eligibility check on all Medicare inpatients to determine HMO status and available days. Communicates any outstanding issues with Financial Counselors and/or case management staff Completes Medicare Secondary Payer Questionnaire for Medicare beneficiaries Properly identifies patients, ensures armband accuracy, inputs demographics information, and secures the required forms to ensure compliance with regulatory policies 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 Delivers excellent customer service by contacting patients to inform them of authorization delays 48 hours prior to their date of service and answers all questions and concerns patients may have regarding authorization status Ensures consistent monitoring of interdepartmental tracking tools to proactively identify patients that require registration to be completed. 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) Ensures patients have logistical information necessary to receive their services (e.g., appointment and time, directions to facility) 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; clearly communicates due dates and amount of each installment. Collects payment plan installments, out-of-pocket costs, outstanding previous balances, and any other applicable amount from patients per policy. Informs patients of any convenient payment options (e.g., portal, mobile apps) and follows deferral procedure as required Connects patients with financial counseling or Medicaid eligibility vendor as appropriate Contacts patient to advise them of possible financial responsibility and connects them with a financial counselor if necessary Performs cashiering functions such as collections and cash reconciliation with accuracy in support of the pre-established legal and financial guidelines of AdventHealth when required Discusses financial arrangements for newborn(s), informs patient of the timeframe for enrolling a newborn in coverage, provides any documentation or guidance for the patient to enroll their child prior to or after the anticipated delivery date, and communicates appropriate information to registration staff as needed The expertise and experiences you’ll need to succeed: · High School Grad or Equiv · 1+ experience Preferred Qualifications: · Associate · 1+ of relevant healthcare experience · Prior collections experience · 1+ of customer service experience · 1+ of direct Patient Access experience · 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 HIPPAA and AdventHealth 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