Patient Access Representative 1 (On-Site) (H)

University of Miami•Miami, FL

4d•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 verification, and confirms patient information accuracy. It involves explaining and obtaining signatures on important documents like Consent for Treatment, Financial Liability, and HIPAA. The representative also schedules, cancels, and edits appointments, records no-shows, and reconciles vouchers. Additionally, they answer telephone calls, respond to inquiries, and adhere to University policies. Department-specific functions include projecting a welcoming demeanor, interacting effectively with patients and the healthcare team, coordinating various functions using multiple systems (EPIC MyChart, Grand Central ADT, Cadence, Prelude, Radiant, OP Time, Care Everywhere, Resolute, Nice inContact Communication, and Aria Oncology), performing pre-service validation, assisting patients with self-serve technology, managing patient flow, obtaining and updating demographic, financial, and clinical information, reviewing insurance eligibility, conducting critical communication regarding legal and compliance documents, answering and triaging calls, collecting and processing currency, performing cash-drawer reconciliation, and making bank deposits. The role requires cross-training for Front-End Revenue Cycle and Clinical Support functions, the ability to float, and knowledge of healthcare regulatory guidelines (OSHA, HIPAA, JC, AHCA, EMTALA, and CMS).

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.
Any relevant education, certifications and/or work experience may be considered.

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 work 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.
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.
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.
Knowledge of health care regulatory guidelines and compliance requirements including but not limited to: OSHA, HIPAA, JC, AHCA, EMTALA, and CMS.