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Sr. Patient Accounts 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.

$1,500 Sign On Bonus

The Department of Neurological Surgery is currently seeking a full time Sr. Patients Account Representative to work in Miami, FL. The Senior Patient Accounts Representative ensures that patient demographic information is accurate and that funding source is billed and collected appropriately. The Senior Patient Accounts Representative uses advanced knowledge of billing procedures and coding expertise to assist management in the training of staff and in assuring compliance with protocols and regulations.

CORE JOB FUNCTIONS

  • Submits claims to insurance companies and follows up on outstanding claims.
  • Processes, remits, and posts payments to patients' accounts.
  • Reconciles monthly charges, identifies any errors, and researches coverage policies.
  • Assists patients with insurance and billing questions.
  • Sets up budget plans on outstanding accounts, mails copies of budget agreements to patients, monitors compliance, and follows up on any payment delinquencies.
  • Receives and reviews patient, insurance, and attorney correspondence, researches issues, and provides written responses.
  • Enters all returned mail and stale checks in the database and researches to acquire updated address information to reprocess items.
  • Recommends policy and procedural changes to management for review as needed.
  • 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 required

Experience:

Minimum of 3 years of relevant experience required

Department Specific Functions

  • Responsible for obtaining authorization for all elective scheduled procedures
  • Working with physician nurse to complete spinal forms for insurance plans as necessary
  • Obtaining CPT codes from Coder to submit authorization request
  • Verifying insurance contracted with Physician and Facility
  • Notifying patient if non-contracted (physician and facility)
  • Notifying patient of financial responsibility (out of pocket, deductible, co-insurance)
  • Requesting Single Case Negotiation letters from 2nd party, once out of network auth is approved
  • Re-verifying eligibility status if cases fall in the in the consecutive month
  • Working in conjunction with PCPs office in obtaining referrals/ authorization
  • Update Insurance information in UChart in a timely manner.
  • Submit/Communicate with 3rd party vendors by sending approvals to the corresponding facility.
  • Updating (JMH)Cerner with the CPT codes
  • Working with international and domestic self-pay teams in requesting quotes
  • Work with Physician, Nurse Liaison and Administrative Assistant to appeal any denial or Peer to Peer review to ensure all procedures are authorize prior to date of service.
  • Set up peer to peer with healthplan
  • Notifying physician of denials
  • Notifying patients of denial or pending cases >3 days prior to surgery
  • Prepare surgical package for Billing with all pertinent information including authorization
  • Attend staff meetings
  • Answers the phone in a prompt and courteous manner, relaying messages accurately and timely.
  • Other duties as assigned

Knowledge, Skills and Attitudes:

  • Skill in completing assignments accurately and with attention to detail.
  • Ability to analyze, organize and prioritize work under pressure while meeting deadlines.
  • Ability to process and handle confidential information with discretion.
  • Proficiency in computer software (i.e. Microsoft Office).
  • Ability to communicate effectively in both oral and written form.

#ED-LI1

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