Patient Access Representative 1 Full Time Bascom Palmer Eye Institute Miami, FL

University of Miami•Miami, FL

2d•Onsite

About The Position

The Patient Access Representative 1 (On-Site) registers patients for clinical services by obtaining pertinent information, verifying insurance benefits, and collecting payments. This role performs full registration, ensures insurance is verified, and all patient information is correct. The representative obtains copies of insurance cards, driver’s licenses, and any applicable referrals. They explain Consent for Treatment, Financial Liability, and HIPAA to patients and obtain signed forms. Additionally, they instruct patients to complete questionnaires, schedule, cancel, and edit appointments, and accurately record no-show patients. The role also involves reconciling all vouchers, answering telephone calls, and responding to inquiries or transferring them when appropriate. Adherence to University and unit-level policies and procedures and safeguarding University assets are also key functions. This list of duties and responsibilities is not intended to be all-inclusive and may be expanded to include other duties or responsibilities as necessary.

Requirements

High school diploma or equivalent
Minimum 1 year of relevant experience
General knowledge of office procedures and operations.
Skill in data entry with minimal errors.
Ability to communicate effectively in both oral and written form.
Skill in completing assignments accurately and with attention to detail.
Ability to process and handle confidential information with discretion.
Knowledge of health care regulatory guidelines and compliance requirements including but not limited to: OSHA, HIPAA, JC, AHCA, EMTALA, and CMS.

Nice To Haves

EPIC MyChart, Grand Central ADT, Cadence, Prelude, Radiant, OP Time, Care Everywhere, Resolute, Nice inContact Communication, and Aria Oncology

Responsibilities

Performs full registration, and ensures that insurance is verified and all patients’ information is correct.
Obtains copies of insurance cards, driver’s license, and any applicable referrals.
Explains Consent for Treatment, Financial Liability, and HIPAA to patients and obtains signed forms.
Instructs patients to complete any questionnaires that might be required by physician.
Schedules follow-up, cancels, and edits appointments, and records no-show patients accurately.
Reconciles all vouchers and delivers them to designated area.
Answers telephone calls and responds to questions and inquiries or transfers when appropriate.
Adheres to University and unit-level policies and procedures and safeguards University assets.
Projects a welcoming professional demeanor.
Interacts and works effectively with patients of all ages, and the healthcare team to ensure a favorable first impression and positive patient experience.
Coordinates wide range of functions from prearrival to discharge utilizing multiple systems including but not limited to: EPIC MyChart, Grand Central ADT, Cadence, Prelude, Radiant, OP Time, Care Everywhere, Resolute, Nice inContact Communication, and Aria Oncology simultaneously and independently to service patients promptly in a fast paced, constantly changing environment.
Performs pre-service validation prior to patient’s appointment for in person or virtual visits.
Assists patients in navigating self-serve technology options including but not limited to MyChart and Self check-in kiosks, in person or remotely.
Coordinates patient flow to ensure timely check-in and arrival to service area.
Obtains, confirms, and accurately enters and updates demographic, financial, and clinical HIPAA protected information.
Reviews real time eligibility insurance responses and/or master contract tool and updates coverages as needed.
Conducts critical communication with patients or legal guardian facilitating the understanding of and obtaining signature on legal, ethical, and compliance related documents that must be presented and thoroughly explained to the patient prior to services being rendered including but not limited to: to Consent for Treatment and Conditions of Admissions, Advance Directives, HIPAA Notice of Privacy, No Surprise Billing, Good Faith Estimate, Off Campus Medicare Co-insurance and Advance Beneficiary Notices, and Medicare Secondary Payer Questionnaire.
Serves as gatekeeper, performs insurance verification, and obtains referrals and/or authorizations as needed.
Provides financial counseling services at check-in, explains benefits, creates estimates, and notifies patients of self-pay liabilities including co-pays, deductibles, co-insurances, global self-pay packages, and previous balances for both hospital technical and professional components and collects thereby reducing AR, Bad Debt, and collection costs by collecting patient’s financial responsibility upfront.
Promotes the use of effective methods of communication and collaborates with providers and clinical team schedulers in coordinating and scheduling complex follow up care onsite or remotely.
Handles high volume of incoming and outgoing calls promptly.
Answers and triages incoming calls, listens to patient/customers’ needs, responds to questions, provides helpful solutions, directs calls, and documents messages using appropriate software in accordance with established protocol.
Collects and processes large amounts of currency and performs end of day cash-drawer reconciliation and timely bank deposits.
Assists department in meeting all established key performance indicator goals: Co-pay, Previous Balances, Estimate Collections, Patient Satisfaction, Accuracy Rates, and Processing Time.
Maintains a close working relationship and open communication with all members of the healthcare team to ensure a seamless check in, check out, clinic flow and positive experience for patients and caregivers.
Recognize, analyze, solve, and de-escalate issues that may arise during workday by applying sound judgement and critical thinking.
Ensures proper physical distancing is always maintained following established guidelines.
Works with healthcare team to resolve unique situations and troubleshoot issues.
Cross trained to carry out all Front-End Revenue Cycle and Clinical Support functions and able to float across all areas and assist as needed.