Remote Insurance Authorization Specialist Part Time Days Virtual Office

Consumer Access Specialist AdventHealth Shawnee Mission

Location Address:

Virtual Office

Top Reasons to Work At AdventHealth Shawnee Mission

• Medical, Dental and Vision Benefits Available Day One
• Received Magnet® recognition from the American Nurses Credentialing Center in January 2019
• Providing faith-based, whole person care to Kansas City since 1962
• Excellent health benefits, an onsite childcare center and fitness facility
• Tuition reimbursement to support continuing education
• Employee Referral Program
• Largest health care provider in Johnson County with three campuses

Work Hours/Shift:

Full Time Days

Monday & Tuesday

8:00AM - 4:30PM

16 hours a week

You Will Be Responsible For:

• 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
• 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
• 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
• 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

What You Will Need:

• One year of customer service experience
• High School diploma or GED

Job Summary:

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.