Rehab Patient Access Representative

Mount Sinai Medical Center; Miami Beach (FL); On-site; USD 42,000 - 54,000; Full time

Benefits offered by this job

Health benefits

Life insurance

Long-term disability coverage

Retirement plan

Paid time off

Tuition reimbursement

Employee assistance program

Wellness program

On-site housing for select positions

Job summary

Mount Sinai Medical Center in Miami Beach, FL, is seeking a Patient Access Representative to support registration and insurance verification for outpatient services. You will collect patient data, verify benefits, and obtain necessary authorizations to ensure timely access to care.

This role requires strong computer skills, excellent communication, and a commitment to compliance with AHCA, HIPAA, and other regulations.

Qualifications

• One year practical experience using computers; experience in registration and insurance verifications preferred.
• Excellent communication and customer service skills are required.
• High school graduate or equivalent; some college preferred.

Responsibilities

• Collects accurate patient information and enters it in the system within established time frames.
• Verifies insurance information and obtains referrals, pre-certifications, and authorizations.
• Greets patients, checks status, and assists with transportation when needed.
• Maintains compliance with AHCA, HIPAA, Medicare, Medicaid and other regulations.
• Ensures registration documents and codes accompany the patient to the appropriate area.

Skills

Computer usage

Registration experience

Insurance verifications

Customer service skills

Communication skills

Education

High school diploma

Some college

Tools

Scheduling program

HPF

QCI

Avility Web MD

RTE applications

Job description

As Mount Sinai grows, so does our legacy in high-quality health care.

Since 1949, Mount Sinai Medical Center has remained committed to providing access to its diverse community. In delivering an unmatched level of clinical expertise, our medical center is committed to recruiting and training top healthcare workers from across the country. We offer the latest in advanced medicine, technology, and comfort in 12 facilities across Miami-Dade (including our 674-bed main campus facility) and Monroe Counties, with 38 medical services, including cancer care, 24/7 emergency care, orthopedics, cardiovascular care, and more. Mount Sinai takes pride in being South Florida’s largest private independent not-for-profit hospital, dedicated to continuing the training of the next generation of medical pioneers.

Culture of Caring: The Sinai Way

Our hardworking, tight-knit community of more than 4,000 dedicated employees fosters an environment of care and compassion. Each member plays a vital role in our collective mission to deliver excellent healthcare through innovation, education, and research. At Mount Sinai, we take pride in our achievements, aiming to be a beacon of quality healthcare in South Florida. We welcome all healthcare professionals to join our thriving community and contribute to our pursuit for clinical excellence.

Department:

CC012580 Outpatient Rehab

Job Description Summary:

Position Responsibilities

• Collects accurate and complete patient information (i.e.. legal name, permanent/local address, phone number, next of kin, employer, guarantor, insurance information, physician etc.,) and enters in the system within the established time frames.
• Verifies insurance information, which include eligibility, benefits (i.e.. Deductibles, co-payments, out of pocket expenses, maximum lifetime coverage, exclusion/limitations/pre-existing conditions, etc.) and obtains appropriate referrals, pre-certification, and/or authorizations for all patient as follows: scheduled patients no later that 24 hours. Unscheduled patients at point of service within the established time frames.
• Enters complete insurance verification information, which includes eligibility, benefits (i.e.. Deductibles, co-payments, out of pocket expenses, maximum lifetime coverage, exclusion/limitations/pre-existing conditions, etc.) in the insurance verification screen and note fields.
• Ensures that a copy of insurance cards, front and back, as well as a copy of a picture ID is obtained and scanned at time patient appears for service.
• Provides and explains all registration documents (i.e.. General consent forms, Advance Directive information, Patient Rights information and Privacy Notice information).
• Greets all patients when they arrive for their appointments. Checks their status and announces their arrival to the therapists. Makes all transportation arrangements for patients that require assistance.
• Assists patient in understanding his/her insurance benefits and explains hospital financial and deposit policies including up front collections. Follows established guidelines for up-front collections and collects and disburses revenue ensuring at all times 100% accuracy of all ledgers and receipts in accordance with established guidelines.
• After completion of registration process, ensures all registration documents, as well as orders, accompany the patient to the appropriate area. Enters specific therapy related occurrence codes as required and maintains accuracy of codes on subsequent registrations throughout the treatment duration.
• Obtains Patient Outcome (FOTO) Surveys and ensures accurate entry into the computer program by the patients and therapists.
• Consistently demonstrates a clear understanding of departmental needs and job functions as assigned by department Manager and/or Team Leader.
• Demonstrates full knowledge of Compliance Advisor’s functionality as it relates to Medicare Compliance and accurately enters diagnosis according to prescription to check for ABN compliance.
• Ensures that every registration has attached correct procedure (PT, OT, ST, CR) , diagnosis (no R/O), printed physician’s name and address on RX/referral and signature of doctor when indicated.
• Maintains compliance of Patient Access processes and Federal State and Local Laws and regulatory standards (AHCA, HIPPA, Medicare, Medicaid, EMTALA, COBRA, etc.).
• Demonstrates knowledge and proper use of scheduling program, department policies regarding cancellations and no shows.
• Demonstrates knowledge and proper use of HPF and QCI.
• Demonstrates knowledge and proper use of Avility Web MD and RTE applications.
• Demonstrates flexibility as well as ability to perform multiple functions within the Patient Access department.
• Demonstrates knowledge and applies customer service strategies at all times.

Qualifications

License/Registration/Certification

• Not applicable

Education

• High school graduate or equivalent level of training. Some college preferred

Experience

• One year practical experience in computer usage. One year prior expiernce in registration, collections and insurance verifications preferred. Excellent communication and customer service skills.

Benefits:

We believe in the physical and mental well-being of our employees and are committed to offering comprehensive benefits that fit their personal needs:

• Health benefits
• Life insurance
• Long-term disability coverage
• Healthcare spending accounts
• Retirement plan
• Paid time off
• Pet Insurance
• Tuition reimbursement
• Employee assistance program
• Wellness program
• On-site housing for select positions and more!

Degree Requirements:

Certification: