Patient Benefits Advisor 2 - Full Time - Bascom Palmer Eye Institute (Miami, FL)

University of Miami•Miami, FL

About The Position

The Patient Benefits Advisor 2 ensures patients have adequate insurance coverage for services received and advises them about gaps in coverage so appropriate payment arrangements can be made. The role provides patient benefit and financial guidance, coordinates prior authorizations and referrals, prepares cost estimates, assists with financial assistance applications and payment arrangements, and supports accurate account documentation and resolution. The position also trains new team members and serves as a subject-matter resource to co-workers and internal customers.

Requirements

High school diploma or equivalent.
At least 2 years of relevant experience.
Strong customer service skills.
Strong written and verbal communication skills.
Highly detail oriented and organized.
Excellent interpersonal skills.
Knowledge of medical terminology.

Responsibilities

Greet individuals by phone or in person with a warm, professional greeting.
Coordinate with scheduling departments when prior authorizations have not been obtained or have been denied.
Assist departments with inquiries about account status, pre-certification, eligibility, financial estimates, and department policies and procedures.
Protect patient information and dispose of paperwork appropriately to preserve confidentiality.
Obtain and document prior authorizations before services are provided.
Contact physician offices to obtain missing patient information.
Use patient estimate tools and contact insurance companies to prepare accurate out-of-pocket estimates, document them, and generate estimate letters.
Update patient accounts with correct insurance information.
Submit insurance referral documentation in a timely manner.
Review schedules and identify patients who are uninsured or underinsured or have previous balances.
Review scheduled services, insurance coverage, previous balances, and payment history, and create detailed estimates.
Develop global packages for self-pay patients or guarantors within 1 to 3 business days to support CMS compliance.
Contact or meet with patients and guarantors to explain health care costs, insurance coverage, and out-of-pocket costs, and provide detailed estimates.
Offer payment plans or identify alternate payment sources before the date of service for patients requesting financial assistance.
Provide financial assistance applicants with a plain-language summary, explain the process, and direct them to the MyChart website to complete the charity application and upload required documents.
Assign financial assistance flags, open financial assistance cases in the Financial Assistance Module, and upload documents provided by patients.
Process telephone credit card payments in accordance with Payment Card Industry security standards and monitor and follow up on pending deposits and payments.
Maintain collaborative working relationships with departments, providers, insurers, and government agencies to assist patients and guarantors with financial obligations.
Provide statements in accordance with established policies and procedures.
Work toward meeting or exceeding individual and departmental key performance indicator goals.
Document collection efforts clearly and follow up on accounts until resolved.
Collaborate with the On-site Patient Access Team, CBO, and clinical departments to resolve charge or outstanding-balance discrepancies.
Train new Patient Benefit Advising team recruits on procedures and systems and serve as a subject-matter resource for co-workers and internal customers.
Adhere to University and unit-level policies and procedures and safeguard University assets.
Perform other duties as assigned.