Patient Access Representative 2 (On-Site) (H) Full Time Bascom Palmer Eye Institute Miami, FL

University of Miami Miller School of Medicine•Miami, FL

54d•Onsite

About The Position

The Patient Access Representative 2 (On-Site) (H) registers patients for clinical services by obtaining pertinent information, verifying insurance benefits, explaining pertinent documents, and collecting payments. CORE JOB FUNCTIONS Obtains, confirms, and enters demographic, financial, and clinical information necessary for financial clearance of scheduled patient accounts. Contacts patients' families or physicians' offices to obtain missing insurance information. Verifies insurance and confirms insurance eligibility of patient coverage benefits, notifying patient and referring physician in the event of failed eligibility. Collaborates with scheduling departments to identify add-on patients. Obtains necessary authorizations, pre-certifications, and referrals. Notifies patients of liabilities and collects funds. Maintains appropriate records, files, and accurate documentation in the system of record. Adheres to University and unit-level policies and procedures and safeguards University assets. 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. Department Addendum Commitment to Service Excellence -Serve as Patient Advocate and Service Ambassador by providing a favorable first impression and proactive attention to internal and external customers in order to meet or exceed expectations, address concerns, and optimize experience. Scheduling - Coordinate scheduling of all walk in, add on, and follow up appointments in accordance with established guidelines and in multiple systems, i.e. UChart Cadence/Prelude/Enterprise Billing, UMCare, and RIS/PAC. Ancillary/Clinic Support Services - Perform ancillary/clinic support duties which vary by hospital departments and specialties (i.e. ER, Admitting, CTU, Imaging, Bariatrics, Dermatology, Infertility, Mental Health, OB GYN, Oral Surgery, Pediatrics, Plastic Surgery, etc.) On-site Registration (Check in/Admission) - Perform all on-site patient access registration related functions promptly without compromising patient safety, quality, service levels, and reimbursement. Insurance Verification/Financial Clearance - Verify insurance eligibility, obtain all applicable referrals/authorizations/pre-certifications, and confirm that non-emergent visits have been financially cleared prior to services being rendered in order to ensure financial reimbursement. Compliance - Comply and abide with all established UHealth policies and procedures related to Patient Access and State/ Federal regulations. Study and Transplant - Identify patients enrolled in a Study/Transplant program and validate that the account reflects the appropriate coverage(s) as it relates to the Study/Transplant program, in order to ensure accurate billing. Collections - Identify and collect patient's self-pay responsibility including co-pays, deductibles, co-insurances, self- pay discount rates, global packages, and previous outstanding balances for both technical and professional components in POS 11 and 22 clinics thereby playing a key role in reducing AR, Bad Debt, and Collection Costs by collecting patient's financial responsibility upfront. Financial Counseling - Provide upfront financial counseling services at time of check-in including identifying alternate funding resources, and establishing payment plans. Discharge / Departure - Coordinate discharge process including identification and collection of additional self-pay charges, prompt scheduling of all follow up appointments, procedures, diagnostic testing, etc., appointment status update, voucher/facility fee reconciliation, and After Visit Summary (AVS). Front End Revenue Cycle Quality Control - Comply with all standard operating procedures established to support key metrics and quality assurance initiatives that contribute toward prompt billing and increased cash flow. Charge Entry - Account for and enter accurate charges within established time frame. Other Duties as assigned based on departmental needs.

Requirements

High school diploma or equivalent required
Minimum 2 years of relevant experience required
Learning Agility: Ability to learn new procedures, technologies, and protocols, and adapt to changing priorities and work demands.
Teamwork: Ability to work collaboratively with others and contribute to a team environment.
Technical Proficiency: Skilled in using office software, technology, and relevant computer applications.
Communication: Strong and clear written and verbal communication skills for interacting with colleagues and stakeholders.
Excellent verbal and written communications skills in English.
Must possess excellent, critical thinking, analytical, troubleshooting, problem resolution, and customer service skills.
Excellent mathematical and cash management skills.
Must be able to function independently and exercise sound judgment in making decisions consistent with departmental guidelines/objectives.
Ability to handle multiple tasks simultaneously and float to multiple areas as needed
Punctuality, attendance, and flexibility essential in order to meet departmental needs and ensure appropriate clinic flow.
Excellent interpersonal skills and ability to work effectively with physicians, co-workers, other departments and patients of all ages, and from across a broad range of cultural and social economic backgrounds.
Ability to work as an integral team member under minimal supervision, in a fast-paced, complex and highly stressful environment
Ability to coordinate, prioritize, and organize work and patient flow.
Ability to show tolerance and sensitivity in stressful situations and safeguard confidential information in accordance with established policies and HIPAA laws.
Computer literate and ability to use multiple systems and acquire proficiency in the following electronic systems: UChart Cadence/Prelude/Enterprise Billing, Passport HealthWorks Compliance Checker, Availity, RIS-PACS, CaneCare, UMCare, Intellidose, MCSL, Experian and all online verification systems used by contracted payors.
High School Diploma required or equivalent
Two (2) years experience in a healthcare related setting. Consideration may be given to an appropriate combination of education/training, and proven experience

Nice To Haves

Bi-Lingual (English/Spanish, English/Creole, English/French, English/Arabic) a plus.
Knowledge of medical terminology preferred.
Bachelor's degree preferred

Responsibilities

Obtains, confirms, and enters demographic, financial, and clinical information necessary for financial clearance of scheduled patient accounts.
Contacts patients' families or physicians' offices to obtain missing insurance information.
Verifies insurance and confirms insurance eligibility of patient coverage benefits, notifying patient and referring physician in the event of failed eligibility.
Collaborates with scheduling departments to identify add-on patients.
Obtains necessary authorizations, pre-certifications, and referrals.
Notifies patients of liabilities and collects funds.
Maintains appropriate records, files, and accurate documentation in the system of record.
Adheres to University and unit-level policies and procedures and safeguards University assets.
Serve as Patient Advocate and Service Ambassador by providing a favorable first impression and proactive attention to internal and external customers in order to meet or exceed expectations, address concerns, and optimize experience.
Coordinate scheduling of all walk in, add on, and follow up appointments in accordance with established guidelines and in multiple systems, i.e. UChart Cadence/Prelude/Enterprise Billing, UMCare, and RIS/PAC.
Perform ancillary/clinic support duties which vary by hospital departments and specialties (i.e. ER, Admitting, CTU, Imaging, Bariatrics, Dermatology, Infertility, Mental Health, OB GYN, Oral Surgery, Pediatrics, Plastic Surgery, etc.)
Perform all on-site patient access registration related functions promptly without compromising patient safety, quality, service levels, and reimbursement.
Verify insurance eligibility, obtain all applicable referrals/authorizations/pre-certifications, and confirm that non-emergent visits have been financially cleared prior to services being rendered in order to ensure financial reimbursement.
Comply and abide with all established UHealth policies and procedures related to Patient Access and State/ Federal regulations.
Identify patients enrolled in a Study/Transplant program and validate that the account reflects the appropriate coverage(s) as it relates to the Study/Transplant program, in order to ensure accurate billing.
Identify and collect patient's self-pay responsibility including co-pays, deductibles, co-insurances, self- pay discount rates, global packages, and previous outstanding balances for both technical and professional components in POS 11 and 22 clinics thereby playing a key role in reducing AR, Bad Debt, and Collection Costs by collecting patient's financial responsibility upfront.
Provide upfront financial counseling services at time of check-in including identifying alternate funding resources, and establishing payment plans.
Coordinate discharge process including identification and collection of additional self-pay charges, prompt scheduling of all follow up appointments, procedures, diagnostic testing, etc., appointment status update, voucher/facility fee reconciliation, and After Visit Summary (AVS).
Comply with all standard operating procedures established to support key metrics and quality assurance initiatives that contribute toward prompt billing and increased cash flow.
Account for and enter accurate charges within established time frame.
Other Duties as assigned based on departmental needs.