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Sr. Surgery Services Representative

3 months ago

Miami, Florida, United States UOMUOMUS 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.

The University of Miami has an exciting opportunity for a Senior Surgery Services Representative in the Department of Patient Access with Bascom Palmer Eye Institute in Palm Beach Gardens, Florida.

The Senior Surgery Services Representative oversees and serves as source of knowledge for junior representatives with the goal of ensuring an excellent healthcare experience for patients. Additionally, the Senior Surgery Services Representative supervises scheduling, reconciliation, and credentialing functions of the department to ensure compliance with guidelines.

CORE JOB FUNCTIONS

  • Acquires operating room schedules and reconciles surgical and anesthesia records.
  • Verifies insurance information and takes appropriate steps to obtain any missing information.
  • Works directly with billing staff and physicians to ensure medical records are complete and in compliance with regulations.
  • Maintains an organized record of charges by batching patient records by date of service.
  • Responds to and resolves complex costumer grievances.
  • 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 3 years of relevant experience

Knowledge, Skills and Attitudes:

  • 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.
  • Ability to work independently and/or in a collaborative environment.
  • Proficiency in computer software (i.e. Microsoft Office).

Department Specific Functions

  • Schedules and registers patients as per established policies and procedures in both the UChart and CARE systems.
  • Performs these tasks accurately with attention to detail to ensure the highest quality of standards and in accordance with all HIPAA guidelines relating to patient confidentiality and privacy.
  • Locates clinic chart, out guides clinic chart to appropriate area and makes copies of clinical notes.
  • Obtains pertinent documents from patients and makes copies for scanning into the UChart scanning system.
  • Validates patient identification by using two main identifiers in addition to patient name (Date of Birth, Social Security Number, and/or Medical Record Number).
  • Creates visit and ensures that the appropriate Patient Type & Location is used during the registration process since this task directly affects the billing process, clinical systems outcome and medical records management.
  • Reviews and verifies registration data in UChart and makes any appropriate changes as necessary including insurance coverage information, Bypass warnings, registration work queues, and completion of Medicare Secondary Payer Questionnaire, if applicable.
  • Interviews patient to determine financial classification status. Reviews financial liability with each patient and explains hospital and professional fees, as well as Global and Flat Fee options. Explains insurance benefits/coverage, if applicable and collects required financial liability. Refers patients unable to meet financial obligations to the on-site Financial Counselor.
  • Documents all financial transactions in UChart.
  • Informs the patient of all required forms, obtains all required signatures, and distributes copies accordingly.
  • Ensures accurate billing of services rendered by checking that the appropriate Financial Status Classification (FSC) and insurance plan has been selected in accordance with UMMG and Hospital Division contract summary protocols and that insurance is pre-verified by performing the following tasks:


• Review visit and check that the FSC and insurance plan are the appropriate and applicable ones according to insurance or self-pay/global study status.


• Refer to Insurance Verifier or verify by utilizing the on line web sites or telephone services, and obtaining eligibility and benefits, as well as, authorizations and referrals, if required.


• Identify non-contracted HMO payers and work with the Business Development Department to ensure that a single case negotiation has been executed.

Assist department's manager with the day to day operations and supervises Surgery Services Representatives in his/her absence

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 time

Employee Type:

Staff

Pay Grade:

H4