Patient Accounts Representative

University of Miami•Miami, FL

4d•Onsite

About The Position

The Patient Accounts Representative coordinates functions of collections and customer service on the individual patient account. This role involves responding to patient or guarantor inquiries, explaining accounts, and making efforts to collect payment in compliance with policies and procedures. The representative will process payments over the phone, follow up on outstanding accounts, set up budget plans, and monitor them for compliance. They will also handle returned mail and stale checks, and perform insurance verifications for Transplant patients to ensure financial clearance throughout their treatment process. Additionally, this role requires updating various systems, communicating with patients regarding accounts or deposits, reviewing charges for accuracy, and ensuring charges are captured and filed correctly. The position also involves monitoring Transplant WQ's, participating in special projects, and researching/resolving collection issues.

Requirements

High School Diploma or equivalent/relevant experience
Minimum 1 year of relevant experience required
Ability to learn new procedures, technologies, and protocols, and adapt to changing priorities and work demands.
Ability to work collaboratively with others and contribute to a team environment.
Skilled in using office software, technology, and relevant computer applications.
Strong and clear written and verbal communication skills for interacting with colleagues and stakeholders.

Responsibilities

Responds to patient or guarantor inquiries on the status of accounts and explains accounts, while making all necessary efforts to collect payment in compliance with policies and procedures.
Processes payments over the phone and when unable to obtain payment follows up on account until payment is received.
Sets up budget plans on outstanding accounts, mails copy of agreements to patients, and reviews plans for compliance.
Follows-up on defaulted agreements with a call or letter and monitors plan until default is resolved.
Reviews on a daily basis all patient, insurance company, and attorney correspondence, researches any issues, and provides written response.
Assists in balancing monthly cash clearing account.
Enters all returned mail and stale check information into the search database, and acquires updated address information to reprocess returned mail and stale checks.
Adheres to University and unit-level policies and procedures and safeguards University assets.
Perform insurance verifications for Transplant patients to provide and maintain financial clearance throughout the Transplant process including referral, evaluation, listing, transplant, and post- transplant related care.
Update all systems including OTTR, UChart, Cerner, and others as needed.
Communicate with patients on accounts or for deposits as needed.
Review Physician and APP’s charges entered for appropriate documentation and procedure coding, and levels of care to ensure accurate and complete charge capture in Mobile Charge.
Follow up to ensure charges are filed in UChart.
Follow up with Physicians and staff for non- captured surgical, inpatient, outpatient, and procedure services.
Create UChart Cases as needed for Transplant bundled payers, SCN’s, and Kidney Acquisition Fund.
Monitor Transplant WQ’s including bundled payers, SCN’s and Kidney Acquisition Fund daily ensuring timely linking and release of charges based on diagnosis, procedure, referring physicians and medical necessity.
Participate in special projects such as Optum/URN online, the Transplant Global Medicaid Bundled program, the Referring Physician Letter Project, or out of state Medicaid Credentialing Packages.
Review for medical record documentation as needed for charge entry, collections, or appeals for inpatient, outpatient, or surgical care.
Follow up with physicians and staff as needed.
Research and use problem solving skills to resolve issues from the collections offices regarding denials, appeals, and cases until resolved.
Other duties as assigned.