Pre-Access Benefits, Precert %26 Authorization Rep – Infusion Center Revenue Cycle – Maitland at AdventHealth

Date Posted: 8/13/2019

Job Snapshot

  • Job Schedule
    Full-Time
  • Location:
    Maitland, FL
  • Job Category
  • Date Posted:
    8/13/2019
  • Job ID:
    284647
  • Job Family
    Patient Financial Services
  • Travel
    No
  • Shift
    Day
  • Application Zone
    2-Legacy System
  • Organization
    AdventHealth Central Florida

Job Description



Pre-Access Benefits, Precert & Authorization Representative – Infusion Center Revenue Cycle – Maitland

AdventHealth Maitland seeks to hire a Pre-Access Benefits, Precert & Authorization Representative who will embrace our mission to extend the healing ministry of Christ.



Facility Profile:

Established in 1908, AdventHealth is one of the largest not-for-profit healthcare systems in the country, caring for more than a million patients each year. The Maitland Office Plaza houses our highly skilled teams that support our hospital system including Marketing, Patient Financial Services, Revenue Management, the Credit Union and Human Resources. The Trickel Building, a two-story office structure, creates an atmosphere of health and healing, with a healthy-style café and quaint chapel. The main lobby is filled with lush greenery and a light trickle of water, creating a holistic environment.



Work Hours/Shifts:

Monday through Friday; 8a – 5p



Job Summary:

Under general supervision, maintains performance standards appropriate to area by obtaining account benefits or verifying authorizations are in place for all scheduled and/or unscheduled patient accounts under responsibility, meeting time line standards established by Leadership for all patient services. Meets or exceeds department audit accuracy standard goal. Uses utmost caution that obtained benefits, authorizations, and/or pre-certifications are accurate according to the actual test/procedure or registration being performed. Adheres to AdventHealth Corporate Compliance Plan and to all rules and regulations of all applicable local, state and federal agencies and accrediting bodies. Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all.



Knowledge, Skills, Education, & Experience Required:

  • Ability to use discretion when discussing personnel/patient related issues that are confidential in nature
  • Responsive to ever-changing matrix of hospital needs and acts accordingly
  • Self-motivator, quick thinker
  • Proficient in Microsoft Office programs such as Outlook, Word, and Excel
  • Ability to communicate professionally and effectively in English, both verbally and in writing
  • Minimum of one year of experience in Patient Financial services department or related area such as registration, finance, collections, customer service, medical office, or contract management
  • High school diploma or GED (Preferred)



Licensure, Certification, or Registration Required:

  • N/A



Job Responsibilities:

Demonstrates through behavior AdventHealth’s Core Values of Keep Me Safe, Love Me, Make it Easy, and Own it as outlined in the organization’s Performance Excellence Program
  • Maintains performance standards appropriate to area by obtaining account benefits or verifying authorizations are in place for all scheduled and/or unscheduled patient accounts under responsibility, meeting time line standards established by Leadership for all patient services.
  • Maintains performance standards appropriate to area by obtaining account benefits or verifying authorizations are in place for all scheduled and/or unscheduled patient accounts under responsibility, meeting time line standards established by Leadership for all patient services.
  • Meets or exceeds audit accuracy standard goal determined by Pre-Access Leadership. Ensures integrity of patient accounts by working error reports weekly (within the Rehab Benefits area) and/or entering appropriate and accurate data. In working inpatient accounts for authorization, is held responsible for denial notification to case management/utilization review, meeting strict timely notification standards and to protect financial standing of AdventHealth.
  • Uses utmost caution that obtained benefits, authorizations, and/or pre-certifications are accurate according to the actual test/procedure or registration being performed. Ensures all benefits, authorizations, pre-certifications, and financial obligations of patients, are documented on account memos, clearly, accurately, precise, and detailed to ensure expeditious processing of patient accounts.
  • When working under Rehab PA POS Float designation: Provides coverage for designated rehab centers that have POS representatives that report to PreAccess; must have reliable transportation as there are various locations in the tri-county area; may be notified of coverage needs at a short notice when warranted. Duties include registering patients, scanning, collection, batching deposits; RMAU and reverifications.
  • Maintains a close working relationship with clinical partners and/or ancillary departments to ensure continual open communication between clinical, ancillary and Patient Access & Patient Financial Services departments. May contact physicians and/or case management/utilization review to facilitate the sending of clinical information in support of the authorization to the payer, as assigned.
  • Monitors team mailbox and/or e-mail inbox, faxes, and/or phone calls, responding to all related Pre-Access account issues, within defined time frames. Exhibits effective time management skills and maintains flexibility by being available for all partners and team. May assist team with reports and projects to maintain team and individual productivity standards and goals.
  • In working patient accounts for benefits; monitors accounts for change in insurance status prior to registration and sends updates to appropriate areas for follow up. In working patient accounts for pre-certification, contacts physician, Patient Access staff, and clinical service area where appropriate, notifying authorization is not obtained by department deadline, advising of visit cancellation, reschedule, or to obtain life or limb order from physician allowing patient to proceed. Contacts patient to notify when visit is rescheduled.
  • Maintains a current and thorough knowledge of utilizing online and system tools available, working from manual reports during system downtime. Maintains sign-on access to online tools in order to provide consistent service to patients, clinical partners, and Patient Access team members.
  • Adheres to HIPAA regulations by verifying pertinent information to determine caller authorization level receiving information on account.
If you want to be a part of a team that is dedicated to delivering the highest quality in patient care, we invite you to explore the Pre-Access Benefits, Precert & Authorization Representative opportunity with Maitland and apply online today.



Job Keywords:

Pre-Access Benefits, Precert, Authorization Representative, Revenue Cycle, Maitland



Position Location:  Maitland
Job:  Patient Financial Services
Organization:  AdventHealth Central Florida
Primary Location:  US-FL-Maitland
Schedule:  Full-time
Shift:  Day
Job Level:  Staff / Associate
Education Level:  None
Travel:  No
Job Posting:  Aug 13, 2019, 10:34:36 AM

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