PreAccess Physician Collaboration and Authorization Specialist

PreAccess Physician Collaboration and Authorization Specialist Outpatient Imaging - AdventHealth Outpatient Imaging

All the benefits and perks you need for you and your family:

• Benefits from Day One
• Paid Days Off 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.

Schedule: Full-time

Shift: Monday-Friday 8-4:30pm

Location: 960 Rinehart Rd, Lake Mary, 32746

The Role You’ll Contribute

The PreAccess Physician Collaboration and Authorization Specialist is responsible for upholding the financial stability of the organization by ensuring the payer receives all information needed to secure authorization prior to a patient receiving a pre-scheduled service. The Pre-Access Physician Collaboration and Authorization Specialist works in partnership with physician offices and other partners to ensure all payer requirements are met to secure an authorization. Maintaining knowledge of payer requirements for authorization and remaining up to date on medical and payer terminology is a key aspect of this role. This role also extends exceptional customer service to patients by contacting them to inform them of their authorization status and prepares them for their financial responsibility prior to their appointment. Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all.

The Value You’ll Bring To The Team

• Multi-disciplinary team that supports all aspects of financially clearing patients prior to their date of service for all facilities in the Central Florida South Region and works in collaboration with the physician office to submit authorization. Contacts insurance companies, as well as physician offices, by phone, fax, or online portal to obtain insurance benefits, eligibility, and to secure and validate authorization information. Responsible for ensuring every effort is made to obtain an authorization from a payer in order to protect the financial stability of to the hospital. Cross trained between 2-5 areas, including imaging, surgery, inpatient, pre-registration or rehab to be able to assist in multiple areas as needed.
• Reviews clinical records when following up on authorization request directly with a payor. Escalates peer to peer (insurance company physician requests to speak to ordering physician) requests to physician offices and assists in scheduling peer to peer requests with the office and the payer to ensure an authorization decision is made prior to date of service. Uses utmost caution that obtained benefits, authorizations, and pre-certifications are accurate according to the actual test and procedure being performed. Ensures all benefits, authorizations, pre-certifications, and financial obligations of patients, are documented clearly, accurately, precise, and detailed to ensure expeditious processing of patient accounts.
• 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. Responsible for pre-registering patients by obtaining demographic information and informing patients of their financial responsibility and collecting payment. Responsible to reschedule any patients that may not want to proceed with service.
• Maintains working knowledge of clinical and third-party payor verification terminology to determine benefit eligibility interpretation of coverage as well as authorization requirements for both complex and non-complex procedures/exams to maximize reimbursement. Serves as the knowledge leader for imaging specific terminology and process and proactively identifies trends and education opportunities and educates team members as needed.
  
  

Minimum Qualifications

The expertise and experiences you’ll need to succeed:

• High School Diploma or GED
• 1 Year experience direct Patient Access
• 1 Year customer service
• Prior collections experience
  
  

Preferred Qualifications

• Associate's Degree
• 2 Years direct Patient Access or customer service experience
• CHAA - Certified Healthcare Access Associate
• Certified Revenue Cycle Representative (CRCR)
  
  

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. The salary range reflects the anticipated base pay range for this position. Individual compensation is determined based on skills, experience and other relevant factors within this pay range. The minimums and maximums for each position may vary based on geographical location.