Benefits, Precert, & Authorization Team Lead – Pre-Access – Maitland

  • Adventist Health System
  • Maitland, FL, USA
  • Nov 17, 2017

Job Description

Pre-Access Benefits, Precert, & Authorization Team Lead - Pre-Access - Maitland
Florida Hospital Maitland seeks to hire Pre-Access Benefits, Precert, & Authorization Team Lead who will embrace our mission to extend the healing ministry of Christ.

Facility Profile:
Established in 1908, Florida Hospital 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.

Department Profile:
The Pre-Access team is responsible for verifying eligibility, creating estimates, and securing authorization for the patients OP or IP visit. The services covered include Imaging, Surgery, Rehab and Inpatient admissions.

Work Hours/Shifts:
Monday - Thursday (shifts between 7am-7pm), Friday (7am-5:30pm), weekends may be required if needed

Job Summary:
Arranges for required precertification and / or benefits for all patient accounts for related area of responsibility. Audits accounts for accuracy regarding authorization and benefits and educates front line staff regarding errors, process changes and payor updates. Provides a single point of contact for initial communication with interdependent departments such as Scheduling, Access, Billing and Medical Management. Performs supervisory duties in absence of Manager. Serves as a mentor and role model to front line staff as well as subject matter expert supporting the manager at interdisciplinary meetings. Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all.

Knowledge, Skills, Education, & Experience Required:
  • Minimum (2) years experience in Patient Access/Patient Financial Services Department or related area (registration, finance, collections, customer service, medical office, contract management).
  • Self-motivator, quick thinker with proficiency in performance of basic math functions
  • Ability of communicating professionally while maintaining confidence, confidentiality, integrity and objectivity with an acceptable use of English and spelling
  • Detail oriented with good organizational, computer, analytical and follow up skills.
  • High School diploma or GED. (Preferred)

Licensure, Certification, or Registration Required:
  • N/A

Job Responsibilities:
Demonstrates through behavior Florida Hospital's Core Values of Integrity, Compassion, Balance, Excellence, Stewardship and Teamwork as outlined in the organization's Performance Excellence Program
  • Monitors and maintains team productivity goal of obtaining benefits and /or pre-certifying all accounts under responsibility at a minimum of seven (7) days out at all times. Responsible for communicating to service line partners of situations where rescheduling is necessary due to lack of authorization and / or limited benefits.
  • Audits performance and provides education to front line staff in order to maintain or exceed accuracy level standards with the ability to travel to employee out-posted locations as necessary.
  • Works closely with service partners and payors to keep current on process and provide feedback and suggestions to management regarding process improvement.
  • Serves as single point of contact for initial communication with service partners and is the 1st stage of the escalation process to management.
  • Runs schedules / reports and distributes to appropriate staff ensuring Reps have work needed at all times and Management is kept apprised of issues in performance or processes in a timely manner.
  • Has a strong working knowledge of all on line eligibility and precertification and eligibility tools: (DDE, Medifax, WebMD, United, Tricare, Humana etc.) and is able to train front line staff on their usage.
  • Presents written and verbal direction to employees to ensure well-informed status of employees in performance of their job requirements as indicated and monitors team time and attendance.
  • 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 Team Lead opportunity with Florida Hospital Maitland and apply online today.

Job Keywords:
Pre-Access, Lead, Patient Registration, Maitland