Sr. Patient Accounts Representative (H)

University of Miami•Miami, FL

65d•Hybrid

About The Position

The University of Miami/UHealth Department of Neurological Surgery has an exciting opportunity for a full time, hybrid Sr. Patient Accounts Representative to work in Miami, FL. The Senior Patient Accounts Representative ensures that patient demographic information is accurate and that funding source is billed and collected appropriately. The Senior Patient Accounts Representative uses advanced knowledge of billing procedures and coding expertise to assist management in the training of staff and in assuring compliance with protocols and regulations.

Requirements

High School Diploma or equivalent/relevant experience, certification or license
Minimum 3 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.

Nice To Haves

Refer to department description for applicable certification requirements

Responsibilities

Submits claims to insurance companies and follows up on outstanding claims.
Processes, remits, and posts payments to patients’ accounts.
Reconciles monthly charges, identifies any errors, and researches coverage policies.
Assists patients with insurance and billing questions.
Sets up budget plans on outstanding accounts, mails copies of budget agreements to patients, monitors compliance, and follows up on any payment delinquencies.
Receives and reviews patient, insurance, and attorney correspondence, researches issues, and provides written responses.
Enters all returned mail and stale checks in the database and researches to acquire updated address information to reprocess items.
Recommends policy and procedural changes to management for review as needed.
Adheres to University and unit-level policies and procedures and safeguards University assets.
Responsible for obtaining authorization for all elective scheduled procedures
Obtains necessary authorizations, pre-certifications, and referrals.
Obtains, confirms, and enters demographic, financial, and clinical information necessary for financial clearance of scheduled patient accounts.
Working with physician nurse to complete spinal forms for insurance plans as necessary
Obtaining CPT codes from Coder to submit authorization request
Contacts patients’ families or physicians’ offices to obtain missing insurance information.
Verifying insurance contracted with Physician and Facility
Verifies insurance and confirms insurance eligibility and facility contracts of patient coverage benefits, notifying patient and referring physician in the event of failed eligibility.
Notifies patients of liabilities prior to date of service and collects funds.
Collaborates with scheduling departments to identify add-on patients.
Deploys critical thinking while responding to a variety of technical issues from patients, physicians and employees via phone, email, web messages, fax, or email.
Works independently and deals effectively with stress, due to heavy workload and the handling of complex patient inquiries.
Recommends new approaches to management for enhancing performance and productivity.
Ability to communicate effectively in both oral and written form.
Ability to process and handle confidential information with discretion.
Ability to analyze, organize and prioritize work under pressure while meeting deadlines
Outstanding interpersonal skills with a commitment to service excellence.
Able to handle multiple tasks, software systems, and technologies simultaneously.
Notifying patient of financial responsibility (out of pocket, deductible, co-insurance)
Requesting Single Case Negotiation letters from 2nd party, once out of network auth is approved
Working in conjunction with PCPs office in obtaining referrals/ authorization
Update Insurance information in UChart in a timely manner.
Submit/Communicate with 3rd party vendors by sending approvals to the corresponding facility.
Working with international and domestic self-pay teams in requesting quotes
Work with Physician, Nurse Liaison and Administrative Assistant to appeal any denial or Peer to Peer review to ensure all procedures are authorized prior to date of service.
Set up peer to peer with healthplan
Notifying physician of denials
Notifying patients of denial or pending cases >3 days prior to surgery
Prepare surgical package for Billing with all pertinent information including authorization
Ability to establish and maintain effective working relationships with patients and staff.
Attend staff meetings
Answers the phone in a prompt and courteous manner, relaying messages accurately and timely.
Other duties as assigned