Job Information

AdventHealth Business Office Specialist - SurgiCare of Rome in Rome, Georgia

Description

Business Office Specialist - AdventHealth SurgiCare of Rome

Location: 16 JOHN MADDOX DR NW; Rome, GA 30165

Top Reasons To Work At AdventHealth Redmond

Faith based organization

Employee Referral Program

Located in the foothills of the North Georgia Mountains

Co-workers that feel like family

Educational Reimbursement Plans

HOURS: MONDAY THROUGH FRIDAY 8AM TO 4:30PM

Primary Responsibilities:

  • 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

  • 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

  • Responsible for registering patients by obtaining critical demographic elements from patients (e.g., name, date of birth, etc.)

  • Confirms whether patients are insured and, if so, gathers details (e.g., insurer name, plan subscriber)

  • Performs Medicare compliance review on all applicable Medicare accounts in order to determine coverage. Identifies patients who may need Medicare Advance Beneficiary Notices of Noncoverage

  • 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

  • Advises patients of expected costs and collects payments or makes appropriate payment

Qualifications

Knowledge and Skills Required:

  • Mature judgement in dealing with patients, physicians, and insurance representatives

  • Working knowledge of Microsoft programs and familiarity with database programs

  • Ability to operate general office machines such as computer, fax machine, printer, and scanner

  • Ability to effectively learn and perform multiple tasks, and organize work in a systematic and efficient fashion

  • Ability to communicate professionally and effectively, both verbally and written

  • Ability to adapt in ever changing healthcare environment

  • Ability to follow complex instructions and procedures, with a close attention to detail

  • Adheres to government guidelines such as CMS, EMTALA, and HIPPAA and AdventHealth corporate policies

  • Knowledge and Skills Required:

  • Mature judgement in dealing with patients, physicians, and insurance representatives

  • Working knowledge of Microsoft programs and familiarity with database programs

  • Ability to operate general office machines such as computer, fax machine, printer, and scanner

  • Ability to effectively learn and perform multiple tasks, and organize work in a systematic and efficient fashion

  • Ability to communicate professionally and effectively, both verbally and written

  • Ability to adapt in ever changing healthcare environment

  • Ability to follow complex instructions and procedures, with a close attention to detail

  • Adheres to government guidelines such as CMS, EMTALA, and HIPPAA and AdventHealth corporate policies

  • Knowledge and Skills Preferred:

  • Understanding of HIPAA privacy rules and ability to use discretion when discussing patient related information that is confidential in nature as needed to perform duties

  • Knowledge of computer programs and electronic health record programs

  • Basic knowledge of medical terminology

  • Exposure to insurance benefits; ability to decipher insurance benefit information

  • Bilingual – English/Spanish

  • Education and Experience Required:

  • One year of customer service experience

  • High School diploma or GED

  • Education and Experience Preferred:

  • One year of relevant healthcare experience

  • Prior collections experience

  • One year of direct Patient Access experience

  • Associate’s degree

  • 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.

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

Category: Patient Financial Services

Organization: AdventHealth Georgia

Schedule: Full-time

Shift: 1 - Day

Travel: Surgicare of Rome Inc

Req ID: 21034915

We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.