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Patient Access Representative 1

2 months ago

Coral Gables, United States InsideHigherEd Full time
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.

**** $1,000 Sign On Bonus ****

The Patient Access department has an exciting opportunity for a full-time Patient Access Representative 1 to work on-site on the UHealth Palm Beach location.

CORE FUNCTIONS:

  • Serve as Patient Advocate and Service Ambassador by providing a favorable first impression and proactive attention to internal and external customers in order to meet or exceed expectations, address concerns, and optimize experience.
  • Perform all on-site patient access registration related functions promptly without compromising patient safety, quality, service levels, and reimbursement.
  • Comply and abide with all established UHealth policies and procedures related to Patient Access and State/ Federal regulations.
  • 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.
  • Perform other duties as assigned based on departmental needs.

Knowledge, Skills, and Abilities:

  • Excellent verbal and written communications skills in English.
  • Must possess excellent, critical thinking, analytical, troubleshooting, problem resolution, and customer service skills.
  • Excellent mathematical and cash management skills.
  • 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.
  • 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.
  • 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.

CORE REQUIREMENTS:

  • High School Diploma required; Bachelor’s degree preferred
  • One (1) year of customer service experience required; experience in a healthcare related setting preferre.
  • Bilingual (English/Spanish, English/Creole, English/French, English/Arabic) a plus.

Any appropriate combination of relevant education, experience and/or certifications may be considered.

DEPARTMENT ADDENDUM

Department Specific Functions

Projects a welcoming professional demeanor. Interacts and works effectively with patients of all ages, and the healthcare team to ensure a favorable first impression and positive patient experience. Coordinates wide range of functions from prearrival to discharge utilizing multiple systems including but not limited to: EPIC MyChart, Grand Central ADT, Cadence, Prelude, Radiant, OP Time, Care Everywhere, Resolute, Nice inContact Communication, and Aria Oncology simultaneously and independently to service patients promptly in a fast paced, constantly changing environment. Performs pre-service validation prior to patient’s appointment for in person or virtual visits. Assists patients in navigating self-serve technology options including but not limited to MyChart and Self check-in kiosks, in person or remotely. Coordinates patient flow to ensure timely check-in and arrival to service area. Obtains, confirms, and accurately enters and updates demographic, financial, and clinical HIPAA protected information. Reviews real time eligibility insurance responses and/or master contract tool and updates coverages as needed. Conducts critical communication with patients or legal guardian facilitating the understanding of and obtaining signature on legal, ethical, and compliance related documents that must be presented and thoroughly explained to the patient prior to services being rendered including but not limited to: to Consent for Treatment and Conditions of Admissions, Advance Directives, HIPAA Notice of Privacy, No Surprise Billing, Good Faith Estimate, Off Campus Medicare Co-insurance and Advance Beneficiary Notices, and Medicare Secondary Payer Questionnaire. Serves as gatekeeper, performs insurance verification, and obtains referrals and/or authorizations as needed. Provides financial counseling services at check-in, explains benefits, creates estimates, and notifies patients of self-pay liabilities including co-pays, deductibles, co-insurances, global self-pay packages, and previous balances for both hospital technical and professional components and collects thereby reducing AR, Bad Debt, and collection costs by collecting patient’s financial responsibility upfront. Promotes the use of effective methods of communication and collaborates with providers and clinical team schedulers in coordinating and scheduling complex follow up care onsite or remotely. Handles high volume of incoming and outgoing calls promptly. Answers and triages incoming calls, listens to patient/customers’ needs, responds to questions, provides helpful solutions, directs calls, and documents messages using appropriate software in accordance with established protocol. Collects and processes large amounts of currency and performs end of day cash-drawer reconciliation and timely bank deposits. Assists department in meeting all established key performance indicator goals: Co-pay, Previous Balances, Estimate Collections, Patient Satisfaction, Accuracy Rates, and Processing Time. Maintains a close working relationship and open communication with all members of the healthcare team to ensure a seamless check in, check out, clinic flow and positive experience for patients and caregivers. Recognize, analyze, solve, and de-escalate issues that may arise during workday by applying sound judgement and critical thinking. Ensures proper physical distancing is always maintained following established guidelines. Works with healthcare team to resolve unique situations and troubleshoot issues. Cross trained to carry out all Front-End Revenue Cycle and Clinical Support functions and able to float across all areas and assist as needed. Knowledge of health care regulatory guidelines and compliance requirements including but not limited to: OSHA, HIPAA, JC, AHCA, EMTALA, and CMS.

AREA SPECIFIC

ER

  • Must possess a good understanding of the unique characteristics and operations of the Emergency Room to proficiently support.
  • Proficient knowledge of ASAP module.
  • Must be flexible and adjust to rotating schedules evenings, weekends, and holidays.
  • Able to perform ADT functions (as described under Admitting section) afterhours, weekends, and holidays.
  • Must adhere to PPE requirements as dictated by the specific situation.

ADMITTING

  • Must possess a good understanding of the unique characteristics and operations of Admitting to proficiently support the area.
  • Proficient knowledge of ADT module.
  • On-call and rotating schedule for evenings, weekends, and holidays.
  • Explains and obtains patient acknowledgment for all required regulatory documents including but not limited to the HIPAA Facility Directory Form, and CMS MOON, HOON, and IMM notices. 
  • Obtains information from patient to complete Patient Self Determination Checklist and collects and scans pertinent documents. 
  • Responsible for obtaining, confirming, and documenting eligibility and benefits, and providing health plan admission notification.
  • Responsible for pre-admissions log to include benefits, specialty, and financial clearance. 
  • Coordinates with bed control on bed availability.
  • Collaborates with Transfer Center on all incoming transfers to finalize transfer requests.
  • Responsible for processing admissions orders received via in-basket messaging.
  • Extensive collaboration with providers, nursing unit, and utilization review department in coordinating admissions.

CTU

  • Must possess a good understanding of the unique characteristics and operations of CTU to proficiently support the area.

HOSPITAL BASED CLINIC

  • Must possess a good understanding of the unique characteristics and operations of the hospital-based department/clinic/division to proficiently support the area.

PRACTICE BASED CLINIC

  • Must possess a good understanding of the unique characteristics and operations of the practice-based department/clinic/division to proficiently support the area.

REMOTE BASED

  • Must possess a good understanding of the unique characteristics and operations of remote based call center operations to proficiently support all Front-End Revenue Cycle and Clinical Support remote functions.

Department Specific Qualifications

Education:

High School diploma or equivalent

Certification and Licensing:

Not Applicable

Experience:

Minimum 1 year of relevant experience.

Any appropriate combination of relevant education, experience or certification may be considered.

A highly motivated individual with the ability to obtain HFMA Patient Access Essentials certification and satisfactorily demonstrate outstanding interpersonal skills with a commitment to service excellence and meeting departmental and individual goals may be considered.

Knowledge, Skills and Attitudes:

  • TIER 1 essential worker that provides critical functions that cannot be paused in traditional and non-traditional healthcare settings.
  • Subject to potential contact/exposure to pandemics and patients with contagious diseases.
  • Able to be available 30 minutes prior to opening and after clinic ends, which fluctuates depending on clinic and provider, in addition to weekends, evenings, holidays, and during disastrous events (e.g., hurricanes, pandemics, etc.)
  • Able to float and provide coverage without advance notice based on daily organizational needs, including working in offsite locations, tents or having to come onsite if working remotely.
  • Onsite presence may be required to fulfill role regarded as vital in the delivery of healthcare services regardless of environmental conditions.
  • Knowledge of health care regulatory guidelines and compliance requirements including but not limited to: OSHA, HIPAA, JC, AHCA, EMTALA, and CMS.
  • Outstanding interpersonal and customer service skills with a commitment to service excellence.
  • Excellent critical thinking, analytical, troubleshooting, and problem-solving skills.
  • Computer literate with the ability to acquire proficiency utilizing multiple systems and technology.
  • Able to handle multiple tasks, software systems, and technologies simultaneously in a fast paced, constantly changing environment.
  • Ability to work as an integral team member under minimal supervision, in a fast-paced, complex, and highly stressful environment.
  • Knowledge of generally accepted accounting principles with excellent mathematical and cash management skills.
  • Ability to establish and maintain effective working relationships with physicians, co-workers, other departments, and patients of all ages, and from across a broad range of cultural and social economic backgrounds.
  • Skill in completing assignments accurately with attention to detail.
  • Ability to work independently and/or in a collaborative environment.
  • Adherence to punctuality and attendance standards, remaining flexible to meet departmental needs and ensure appropriate clinic flow.

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.

Patient safety is a top priority. As a result, during the Influenza ("the flu") season (September through April), the University Of Miami Miller School Of Medicine requires all employees who provide ongoing services to patients, work in a location (all Hospitals and clinics) where patient care is provided, or work in patient care or clinical care areas, to have an annual influenza vaccination. Failure to meet this requirement will result in rescinding or termination of employment.

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 timeEmployee Type:StaffPay Grade:H3