Sr. Patient Access Representative

University of Miami; United States; On-site; USD 42,000 - 64,000; Full time

Job summary

The University of Miami in Miami, FL is seeking a Sr. Patient Access Representative to oversee pre-registration and clearance activities and serve as a functional expert for department peers.

You will document data to facilitate reimbursement for services and support accurate insurance verification across multiple interventional procedures. Responsibilities include obtaining demographic and financial information, verifying insurance, coordinating with scheduling, and processing authorizations.

Qualifications

• High School diploma or equivalent.
• Minimum 1 year of relevant experience.
• Knowledge of generally accepted accounting procedures and principles.
• Skill in completing assignments accurately and with attention to detail.
• Ability to process and handle confidential information with discretion.
• Ability to work independently and/or in a collaborative environment.
• Ability to communicate effectively in both oral and written form.
• Any relevant education, certifications and/or work experience may be considered.

Responsibilities

• Obtains, confirms, and enters demographic, financial, and clinical information necessary for financial clearance of scheduled patient accounts.
• Contacts patients’ families or physicians’ offices to obtain missing insurance information.
• Verifies insurance and confirms insurance eligibility of patient coverage benefits, notifying patient and referring physician in the event of failed eligibility.
• Collaborates with scheduling departments to identify add-on patients.
• Schedule Interventional procedures, Procedure coding, Medication Prior Authorizations.
• Obtains necessary authorizations, pre-certifications, and referrals.
• Notifies patients of liabilities prior to date of service.
• Recommends new approaches to management for enhancing performance and productivity.
• Maintains appropriate records, files, and accurate documentation in the system of record.
• Adheres to University and unit-level policies and procedures and safeguards University assets.
• Department Specific Functions Identify, process, and track procedure peer to peers; Employee will process medication prior to authorizations; Coordination with physicians for attorney conference calls and/or depositions; Responsible for the completion of Worker’s Compensation DWC25 forms; Scheduling and coding interventional procedures; Review of clinical schedules (DAR); Create, submit, and follow up with Medication and interventional procedure appeals.

Skills

Attention to detail

Communication skills

Discretion with confidential info

Independent / collaborative

Education

High School diploma or equivalent

Job description

The University of Miami/UHealth Department Anesthesiology has an exciting opportunity for a full-time. Sr. Patient Access Representative to work in Miami, FL. The Sr. Patient Access Representative oversees pre-registration and clearance activities and serves as functional expert for department peers. Further, the Sr. Patient Access Representative assumes responsibility for documenting all necessary data that will facilitate reimbursement for services rendered by the department.

CORE JOB FUNCTIONS

• Obtains, confirms, and enters demographic, financial, and clinical information necessary for financial clearance of scheduled patient accounts.
• Contacts patients’ families or physicians’ offices to obtain missing insurance information.
• Verifies insurance and confirms insurance eligibility of patient coverage benefits, notifying patient and referring physician in the event of failed eligibility.
• Collaborates with scheduling departments to identify add-on patients.
• Schedule Interventional procedures Procedure coding Medication Prior Authorizations
• Obtains necessary authorizations, pre-certifications, and referrals.
• Notifies patients of liabilities prior to date of service.
• Recommends new approaches to management for enhancing performance and productivity.
• Maintains appropriate records, files, and accurate documentation in the system of record.
• Adheres to University and unit-level policies and procedures and safeguards University assets.
• Department Specific Functions Identify, process, and track procedure peer to peers Employee will process medication prior to authorizations Coordination with physicians for attorney conference calls and/or depositions Responsible for the completion of Worker’s Compensation DWC25 forms Scheduling and coding interventional procedures Review of clinical schedules (DAR) Create, submit, and follow up with Medication and interventional procedure appeals
• 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

• High School diploma or equivalent
• Minimum 1 years of relevant experience
• Knowledge of generally accepted accounting procedures and principles.
• Skill in completing assignments accurately and with attention to detail.
• Ability to process and handle confidential information with discretion.
• Ability to work independently and/or in a collaborative environment.
• Ability to communicate effectively in both oral and written form.
• Any relevant education, certifications and/or work experience may be considered.

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. Applicants and employees are protected from discrimination based on certain categories protected by Federal law.

Job Status: Full time Employee Type: Staff

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. 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 of Miami is an Equal Opportunity Employer. Applicants and employees are protected from discrimination based on certain categories protected by Federal law.