Benefits, Precert, & Authorization Representative – Pre-Access – Maitland

  • Adventist Health System
  • Orlando, FL, USA
  • Dec 22, 2017
Healthcare

Job Description

Pre-Access Benefits, Precert, & Authorization Representative - IP Certification - Maitland
IP Certification seeks to hire Pre-Access Benefits, Precert, & Authorization Representative 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 2,286-bed acute-care medical facility, comprised of eight hospitals, has been recognized by U.S. News & World Report as one of the best hospitals in the country for the past 10 years. It serves as a community hospital for Greater Orlando and as a major tertiary referral hospital for Central Florida and much of the Southeast, the Caribbean and Latin America.

Work Hours/Shifts:
Full Time: Hours of operation are 7:00am-7:00pm (includes weekends)

Shifts will vary from 7:00am-3:30pm or 10:30am-7:00pm

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 Florida Hospital 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 1-year experience in Patient Financial Services Department or related area (registration, finance, collections, customer service, medical office, contract management).
  • 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
  • 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 Florida Hospital.
  • 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 assists 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 IP Certification and apply online today.

Job Keywords:
Registration Representative, Authorization Representative, Patient Registration, PreAccess

Reference

256608