Patient Access Representative 1 (On-Site) - Full Time Bascom Palmer Eye Institute - Miami. FL

University of Miami; Miami (FL); On-site; USD 35,000 - 55,000; Full time

Job summary

An established industry player is seeking a dedicated Patient Access Representative to join their dynamic team in Miami. In this full-time role, you will be responsible for registering patients, verifying insurance, and ensuring a smooth check-in process. This position offers a unique opportunity to contribute to the healthcare experience while working in a fast-paced environment. You will be part of a team that values compassion, professionalism, and attention to detail, making a real difference in the lives of patients. If you are passionate about customer service and healthcare, this role is perfect for you.

Benefits

Medical Insurance

Dental Insurance

Tuition Remission

Flexible Schedule

Paid Time Off

Qualifications

• 1 year of experience in a healthcare or customer service setting preferred.
• Ability to communicate effectively in both oral and written form.
• General knowledge of office procedures and operations.

Responsibilities

• Register patients for clinical services and verify insurance benefits.
• Schedule appointments and maintain accurate patient records.
• Provide financial counseling and collect patient payments.

Skills

Data Entry

Communication Skills

Customer Service

Attention to Detail

Confidentiality

Education

High School Diploma

Bachelor’s Degree

Tools

UChart Cadence

Enterprise Billing

RIS/PACS

Job description

Patient Access Representative 1 (On-Site) - Full Time Bascom Palmer Eye Institute - Miami. FL page is loaded

Patient Access Representative 1 (On-Site) - Full Time Bascom Palmer Eye Institute - Miami. FL

Apply locations Miami, FL time type Full time posted on Posted 2 Days Ago job requisition id R100087421

Current Employees:

If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position using the Career worklet, please review this tip sheet .

The University of Miami, Bascom Palmer Eye Institute, has an exciting opportunity for a full time Patient Access Representative 1 (On-Site) in Miami, Florida.The Patient Access Representative 1 (On-Site) registers patients for clinical services by obtaining pertinent information, verifying insurance benefits, and collecting payments.

CORE JOB FUNCTIONS

• Performs full registration and ensures that insurance is verified, and all patients’ information is correct.

• Obtains copies of insurance cards, driver’s license, and any applicable referrals.

• Explains Consent for Treatment, Financial Liability, and HIPAA to patients and obtains signed forms.

• Instructs patients to complete any questionnaires that might be required by physician.

• Schedules follow-up, cancels, and edits appointments, and records no-show patients accurately.

• Reconciles all vouchers and delivers them to designated area.

• Answers telephone calls and responds to questions and inquiries or transfers when appropriate.

• 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.

CORE QUALIFICATIONS

Education:

High school diploma or equivalent

Experience:

Minimum 1 year of relevant experience

Knowledge, Skills and Attitudes:

• General knowledge of office procedures and operations.

• Skill in data entry with minimal errors.

• Ability to communicate effectively in both oral and written form.

• Skill in completing assignments accurately and with attention to detail.

• Ability to process and handle confidential information with discretion.

• Project a professional appearance and demeanor including appropriate body language and vocal tone.

• Immediately recognize and acknowledge internal and external customers in a welcoming, courteous and professional manner.

• Respect the privacy, dignity and confidentiality of our patients and be responsive to their needs by showing concern, empathy, patience and respect.

• Maintain composure during stressful situations and use sound judgment.

• Provide immediate service recovery by taking ownership of any problems that may arise and resolving them utilizing appropriate rationale.

• Provide patients with and interpret Patient Rights and Responsibilities.

Department Specific Functions

1. 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.

• Enter and/or update all pertinent data including demographics, financial, and referring physician information.

• Interact with patients and collaborate with providers and clinicians to appropriately schedule appointments taking into account scheduling guidelines per division/specialty/provider, resource availability, special needs, timeframes, medical necessity, and payer and contractual guidelines.

• Determine appointment type and utilize analytical skills to determine appropriate slot utilization and instances when overbooking is appropriate.

• Obtain and document pertinent insurance verification information (i.e. CPT codes, service description, reason for visit, etc.) needed to obtain authorization/pre-cert in order to avoid denials and ensure financial reimbursement.

• Coordinate multiple appointments with appropriate sequence and proper time allotted between appointments.

• Communicate to patient the place of service where each appointment will take place (i.e. POS 11 vs. 22) and how it may impact his/her financial responsibility.

2. 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.) that include but are not limited to the following:

• UChart Office Assistant functions and monitoring of Provider’s In Basket Messaging

• Processing of Back to Work or School Requests, and Immunization Records

• Scanning Imaging Results

• Preparing Charts/Medical Records

• Processing of Medical Record Release of Information

• Prescription Refill Requests

• Test Results Requests

• Treatment Plans

• Appt. Reminder Calls

• Bump Lists

• Surgery Scheduling

• Coordination of External Referrals

• Promotion and Sales of Over the Counter Products

• Inventory and Ordering of Supplies

• Ordering of DME products

• Bed Assignments

• Pre-certifications

3. 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.

• Obtain legal photo identification and (if applicable) insurance card (s), and validate patient identity and coverage (if applicable) prior to services being rendered thereby ensuring patient safety and financial reimbursement.

• Scan ID, insurance card (s), advance directives, share of cost letters, and any other pertinent documents.

• Obtain and/or verify that all demographic, financial, and insurance coverage information is accurate, up to date and complete, and that financial clearance has been obtained inclusive of all required referrals/authorizations.

• Explain all applicable forms (i.e. Consent for Medical Treatment and Conditions of Admission, Acknowledgement of Receipt of Privacy Practices, Questionnaires, Important Message from Medicare,

• Advance Directives Checklist, and answer any questions patients’ may have pertaining to form(s) and established policies.

• Obtain and witness all patient/guarantor signatures on all applicable consents and forms, and ensure that all initial and signature areas required have been completed and forms have been dated, timed and labeled.

• Print out labels and/or any forms required by treatment area.

• Complete check-in and registration process as rapidly as possible (without compromising quality or service level) in order to minimize the time patients must wait for treatment to begin.

4. 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.

• Verify insurance eligibility and authorization requirements for walk-ins and add-ons utilizing multiple automated on-line resources or telephone.

• Identify point of service (POS) 11 versus 22 and obtain verification and referral/authorization accordingly.

• Provide patient/guarantor with detailed benefit and authorization requirements and co-pay, deductible, and co-insurance self–pay responsibility for POS 11 and 22.

• Ensure that the appropriate payer has been selected (i.e. Indemnity, HMO, PPO, POS, Auto, W/C, etc.) and that all the required data elements and referrals and authorizations based on CPT, ICD 9, and services being rendered have been obtained and accurately entered in system in order to avoid claim rejections.

• Refer non-contracted payers for single case negotiation.

• Determine appropriate filing order if patient is covered by more than (1) payer.

• Financially clear visits once insurance has been verified and referral/authorizations obtained.

• Generate HAR (Hospital Account Record) for all services rendered at a point of service 22 (POS 22), and assigns HAR’s to appointments accordingly.

.

5. Compliance

Comply and abide with all established UHealth policies and procedures related to Patient Access and State/ Federal regulations.

MSPQ

• Complete the Medicare Secondary Payer Questionnaire (MSPQ) at time of scheduling prior to services being rendered and in accordance with Centers for Medicare & Medicaid Services (CMS) Federal regulations.

ABN

• Utilize medical necessity software to determine if an Advance Beneficiary Notice (ABN) is applicable in order to produce and provide all Medicare patients with an ABN in accordance with CMS Federal regulations prior to services being rendered. Explain ABN in detail and allow patient to make an informed decision and document in system.

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.

6. 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.

• Exercise sound judgment so as not to delay treatment for emergency medical conditions and necessary stabilizing treatments, due to patient’s financial responsibility and collection efforts.

• Determine and collect patient’s estimated financial responsibility for both POS 22 and POS 11 (i.e. deductible, co-payment, co-insurance, prompt payment discounts or global fee based on CPT/ICD9 codes).

• Explain charges, fees, and previous balances for both technical and professional components.

• Offer forms of payment including cash, checks, and credit cards.

• Check for counterfeit bills when collecting cash and obtain authorization for all credit card transactions.

• Post payment(s) as applicable for both POS 11 and 22, and issue system generated receipt(s).

• Reconcile all collections and transactions at the end of the shift including initial cash bag funds.

• Prepare daily deposit(s) for Med Finance, Main Cashier, or contracted armored pick up service.

• Document any and all collection details including discounts, global fees and partial payments in system and select applicable billing indicators and FYI Global/Discount flags.

7. Financial Counseling

Provide upfront financial counseling services at time of check-in including identifying alternate funding resources, and establishing payment plans.

• Advise patients of financial obligations and collect according to established guidelines and financial policies.

• Identify alternate funding sources and offer global or discount.

• Identify patients which have been deemed eligible for charity care or financial hardship and determine if services being rendered are encompassed in charity approval.

• Assist patients in establishing payment plans.

8. 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).

• Determine upon checkout/discharge any pending financial responsibility, and collect and post payment(s) accordingly.

• Systematically reflect the checkout/discharge status by carrying out the checkout function and updating the appointment status to complete.

• Check discharge orders and coordinate the prompt scheduling of any and all follow up appointment(s)/procedure(s), diagnostic or ancillary services ordered.

• Print and provide the patient with an After Visit Summary (AVS).

• Obtain applicable vouchers, facility fee, and/or secondary forms and screen for accuracy.

9. 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.

• Identify systematic warning flags/messages and populate required data elements in order to eliminate by- passed warnings/errors and avoid a negative impact on downstream revenue cycle processes.

• Monitor and clear patient work queues on a daily basis to ensure data integrity, prompt billing and minimal AR days.

• Populate any and all required data to ensure the checklist at the end of the arrival process reflects as complete for each category.

10. Charge Entry

Account for and enter accurate charges within established time frame.

• Enter charge codes and amount of units accurately and within (1) business day of services being rendered.

• Perform daily reconciliation to identify missing charges and follow up with clinicians to obtain in order to ensure all rendered services are accounted for and billed.

• Maintain a 3 calendar day maximum lag in order to ensure prompt billing and increased cash flow.

11. End of Day (EOD)

Perform end of day duties to ensure the accuracy of all appointment/visit statuses in system.

• Review DAR and identify appointments that are not in completed status

• Contact clinicians to confirm appropriate status of each appointment.

• Update status accordingly (i.e. no-show, left without being seen, canceled, etc.).

12. Other Duties

Perform other duties as assigned based on departmental needs.

• 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.

• Knowledge of medical terminology preferred.

• 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.

Education Requirements (Essential Requirements) :

• High School Diploma required.

• Bachelor’s degree preferred.

Work Experience Requirements (Essential Requirements):

• One (1) year experience in a healthcare or customer service related setting preferred. Consideration may be given to an appropriate combination of education/training, and proven experience.

The University of Miami offers competitive salaries and a comprehensive benefits package including medical, dental, tuition remission and more.

UHealth-University of Miami Health System, South Florida's only university-based health system, provides leading-edge patient care powered by the ground breaking research and medical education at the Miller School of Medicine. As an academic medical center, we are proud to serve South Florida, Latin America and the Caribbean. Our physicians represent more than 100 specialties and sub-specialties, and have more than one million patient encounters each year. Our tradition of excellence has earned worldwide recognition for outstanding teaching, research and patient care. We're the challenge you've been looking for.

The University of Miami is an Equal Opportunity Employer - Females/Minorities/Protected Veterans/Individuals with Disabilities are encouraged to apply. Applicants and employees are protected from discrimination based on certain categories protected by Federal law. Click here for additional information.

Job Status:

Full time

Employee Type:

Staff

Pay Grade:

H3

Similar Jobs (6)

Patient Access Representative 1 (On-Site)

locations Miami, FL time type Full time posted on Posted 15 Days Ago

Patient Access Representative 1 (On-Site) (H)

locations Miami, FL time type Full time posted on Posted 30+ Days Ago

Patient Access Representative 1 (On-Site)

locations Miami, FL time type Full time posted on Posted 24 Days Ago

The mission of the University of Miami is to transform lives through education, research, innovation, and service. A vibrant and diverse academic and healthcare community, the University of Miami and the University of Miami Health System ("UHealth") have rapidly progressed to become one of the nation’s top research universities and academic medical centers in the nation.

The University comprises 12 schools and colleges serving undergraduate and graduate students in more than 350 majors and programs. Visit welcome.miami.edu/about-um to learn more about our points of pride.

The University ranks No. 55 on U.S. News & World Report’s 2022 Best Colleges list and ranked No. 49 in the 2022 Wall Street Journal/Times Higher Education College Rankings.

Bascom Palmer Eye Institute is ranked the #1 eye hospital in the USA and offers some of the nation's premiere eye doctors to treat every eye condition for adults. Sylvester Comprehensive Cancer, part of the Miller School of Medicine, received the prestigious National Cancer Institute designation in 2019.

The University of Miami and UHealth have also ranked among the Forbes Best Employers and Best Employers for Women on several occasions, most recently in 2022.

Transforming lives

With more than 17,000 faculty and staff, the University strives for excellence, and is driven by a powerful mission to transform and impact the lives of its students, patients, members of the community, and people across the globe.

The University is committed to fostering a culture of belonging, where everyone feels valued and has the opportunity to add value. Through values of Diversity, Integrity, Responsibility, Excellence, Compassion, Creativity, and Teamwork (DIRECCT) the U community works together to create an environment driven by purpose, excellence, community, and service.