Patient Access Representative 3 (On-Site)

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The University of Miami UHealth – department of Patient Access has an exciting opportunity for a Patient Access Representative 3.

CORE JOB SUMMARY

The Patient Access Representative 3 (On-Site) oversees the registration and financial clearance activities that will facilitate reimbursement for services rendered by the department and serves as functional expert for department peers.

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.

• Obtains necessary authorizations, pre-certifications, and referrals.

• Notifies patients of liabilities prior to date of service and collects funds.

• Maintains appropriate records, files, and accurate documentation in the system of record.

• Recommends new approaches to management for enhancing performance and productivity.

• Adheres to University and unit-level policies and procedures and safeguards University assets.

Department Specific Functions:

• Serves as Lead resource and functional expert. 

• Ensures smooth patient flow. 

• Provides supervisory coverage in the absence of Supervisor. 

• Identifies and recommends new approaches to management for enhancing team performance and productivity. 

• 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.

• 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 curre