Departmental Assistant - Patient Benefit and Referral Specialist

University of Massachusetts Amherst • Amherst, MA

77d • $24 - $30

About The Position

Accurately performs all functions related to the patient intake process at University Health Services (UHS) by interviewing patients, verifying eligibility electronically via multi-payer systems and entering or updating information in the practice manager in a timely manner and with a high degree of accuracy. Ensures the facility will be reimbursed for the services performed by verifying eligibility and benefits and obtaining pre-determinations and authorizations. Assures timely access to care for patients. Collects co-pays and fee-for-service payments and prepares electronic reconciliation of daily log. Processes telephone traffic and urgent situations in a timely manner, supports and assists various departments, and utilizes the computer system to locate patients and providers. Verifies that all patients are complying with the UHS Eligibility policy.

Requirements

• Associate Degree from an accredited Medical Assistant Program or successful completion of certification as a Certified Medical Assistant, or high school diploma with at least 3 years of medical office experience.
• Prior experience with insurance verification, authorization and predetermination.
• Good oral and written communication skills including telephone etiquette.
• Knowledge of insurance plans; ability to understand and communicate detailed and complex health plan information to clientele.
• Practice management and electronic health record (EHR) proficiency.
• Excellent customer service skills and the ability to de-escalate front line customer service challenges.
• Ability to effectively communicate with colleagues, the public and other UHS staff.
• Strong computer, typing and oral communication skills, including telephone customer service skills.
• Experience working with Microsoft Excel or similar software.
• Working knowledge of basic hospital/clinic practice management and medical terminology.

Nice To Haves

• Experience in a multi-practice facility.

Responsibilities

• Accurately performs all functions related to the patient intake process by interviewing patients, verifying eligibility electronically via multi-payer systems and entering or updating information in the practice manager in a timely manner and with a high degree of accuracy.
• Provides pre-determination of benefits and educates and informs patients about their responsibilities including co-pays and coordination of benefits.
• Addresses electronic eligibility alerts and contacts patients whose insurances are inactive with advance notice to be in compliance with the payer's timely filing requirements.
• Collaborates with the Billing and Coding Departments for maximizing reimbursement of services provided.
• Provides patients with courteous, friendly, fast and efficient services.
• Maintains and demonstrates current knowledge of commercial insurances and requirements of plans accepted at UHS.
• Tracks outgoing referrals for completion and compliance, compiles data and prepares reports on a monthly basis.
• Schedules and manages routine and walk-in appointments for a multidisciplinary practice, adhering to the guidelines set forth by the providers.
• Processes referrals and orders accordingly, to specialist groups or outside imaging facilities.
• Reviews patient insurance plans to determine whether or not authorization is necessary, and if so, obtains authorization from the patient's primary care provider or insurance company to facilitate patient care in-house and at specialist groups outside of UHS.
• Manages incoming phone calls for all aspects of medical care including but not limited to appointments, prescription refills, test results and messages to providers.
• Prepares documentation and information pertinent to the patient's appointment.
• Processes incoming referrals from outside primary care providers to allow patients to continue care at UHS while on campus.
• Uses and manages systems to facilitate patient care at UHS, such as the Trext waiting system to alleviate patient wait times.
• Manages UHS Parkmobile system accurately to provide parking privileges to patients in the designated lot.
• Provides cross-coverage and back-up staffing support to other functions of the front-line staff, when needed.
• Maintains patient confidentiality at all times utilizing current HIPAA guidelines.
• Participates in annual UHS training and monthly departmental meetings to improve the quality of service provided to patients.

Benefits

• This is a temporary, non-benefited position.

What This Job Offers

• Job Type: Part-time
• Industry: Religious, Grantmaking, Civic, Professional, and Similar Organizations
• Education Level: Associate degree
• Number of Employees: 11-50 employees