Patient Access Specialist (On-Site)

University of Miami•Fort Lauderdale, FL

4d•Onsite

About The Position

The Patient Access Specialist coordinates complex duties supporting front-end revenue cycle and clinic functions for hospital and clinic operations, with a focus on financial clearance and the patient experience. The role serves as a functional expert for department peers, supports adherence to established policies and procedures, and provides a lead resource for lower-level Patient Services staff. It also assists with staff training, productivity and quality monitoring, and recommendations to management to improve performance and productivity. The position supports patients throughout the care process, from prearrival through post-discharge services. Duties include gathering and entering demographic, financial, and clinical information; verifying eligibility and benefits; obtaining authorizations and referrals; explaining financial responsibilities and collecting payments; completing required consents and notices; coordinating appointments and follow-up care; maintaining accurate records; and assisting patients with self-service technology. The Specialist handles high volumes of calls and transactions, monitors work queues, reconciles cash drawers and deposits, and collaborates with clinical and non-clinical teams to support effective clinic flow and a positive patient experience. The role requires independent work in a fast-paced, changing environment, effective handling of complex inquiries and stressful situations, and flexibility to meet departmental needs. Depending on the assigned area, responsibilities and requirements may include supporting Emergency Room, Admitting, CTU, hospital-based clinic, practice-based clinic, or remote call-center operations. Certain assignments require rotating or on-call schedules, including evenings, weekends, and holidays, and may involve contact with patients who can transmit infectious diseases.

Requirements

High school diploma or equivalent.
Minimum 3 years of relevant experience.
Skill in data entry and completing assignments accurately with attention to detail.
Effective oral and written communication skills.
Ability to handle confidential information with discretion.
Ability to analyze, organize, and prioritize work under pressure while meeting deadlines.
Outstanding interpersonal and customer service skills with a commitment to service excellence.
Ability to handle multiple tasks, software systems, and technologies simultaneously and to adapt quickly to new systems.
Ability to establish and maintain effective working relationships with patients and staff, including patients and customers of all ages and cultural backgrounds.
Knowledge of generally accepted accounting procedures and principles; excellent mathematical and cash-management skills.
Ability to plan, organize, measure, and integrate priorities and deadlines.
Punctuality and attendance, with flexibility to meet departmental needs and ensure appropriate clinic flow.
Availability 30 minutes before opening and after clinic ends, as schedules fluctuate, and availability for weekends, evenings, holidays, and disaster events such as hurricanes and pandemics.
Proficient knowledge of healthcare regulatory guidelines and compliance requirements, including OSHA, HIPAA, JC, AHCA, EMTALA, and CMS.
Critical-thinking and analytical skills to evaluate systems requirements, develop methodologies, and recommend ways to maximize efficiency and performance.
Skill in examining and reengineering operations and procedures, formulating policy, and developing and implementing strategies and procedures.
Ability to identify, analyze, and interpret complex data and resolve operational problems using sound judgment and critical thinking.
Ability to anticipate and react calmly in emergencies and handle difficult or stressful situations with professional composure.
Ability to establish collaborative relationships with clinical and non-clinical teams and to influence and motivate team members onsite and remotely.
For Emergency Room assignments, understanding of ER characteristics and operations, flexibility for rotating schedules, evenings, weekends, and holidays, and proficiency with the ASAP module.
For Admitting assignments, understanding of Admitting operations and proficiency with the ADT module; availability for on-call and rotating schedules, evenings, weekends, and holidays.
For CTU, hospital-based clinic, practice-based clinic, or remote-based assignments, understanding of the assigned area's operations and functions.
Any relevant education, certifications, and/or work experience may be considered.

Responsibilities

Obtain, confirm, and accurately enter demographic, financial, and clinical information needed for financial clearance and patient services.
Contact patients’ families or physicians’ offices to obtain missing insurance information.
Verify insurance eligibility and benefits, and notify patients and referring physicians when eligibility fails.
Collaborate with scheduling departments to identify add-on patients and coordinate complex follow-up care with providers and clinical schedulers.
Obtain authorizations, pre-certifications, and referrals.
Notify patients of financial liabilities before service, provide financial counseling and estimates, explain benefits, and collect funds.
Maintain appropriate records, files, and accurate documentation in the system of record.
Serve as a lead resource and functional expert for Patient Services staff, provide on-the-job training, and assist with monitoring staff productivity and work quality.
Recommend approaches to management to enhance performance and productivity, and provide updates on progress and changes in scope, schedule, and resources.
Respond to technical issues and patient inquiries through phone, email, web messages, and fax, and handle high volumes of inbound and outbound calls.
Monitor and maintain work queues, navigate multiple systems, and assist patients with self-service technology in person or remotely.
Perform pre-service validation for in-person and virtual visits.
Communicate with patients or legal guardians to explain and obtain signatures on required consents, assignments of benefits, and notices before services are rendered.
Process transactions accurately and promptly, handle currency, reconcile cash drawers at the end of the day, and make bank deposits.
Maintain close working relationships with clinical team members to support seamless check-in and check-out flow and a positive patient and caregiver experience.
Work toward established key performance indicators, including collections, patient satisfaction, accuracy, and processing time.
Identify, analyze, and interpret complex data and resolve operational problems.
Follow University and unit policies and procedures, safeguard University assets, and maintain a professional, welcoming demeanor.
For Emergency Room assignments, support ER operations, perform ADT functions after hours and on weekends or holidays, and follow PPE requirements.
For Admitting assignments, explain and obtain acknowledgment of regulatory documents; complete patient self-determination checklists; collect and scan documents; document eligibility, benefits, and admission notifications; maintain pre-admission logs; coordinate bed availability and transfers; process admission orders; and collaborate with providers, nursing units, and utilization review.
Perform other duties as assigned.