Sr. Patient Accounts Representative (H)

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The University of Miami/UHealth Department of Neurological Surgery has an exciting opportunity for a full time, hybrid Sr. Patient Accounts 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/relevant experience, certification or license

• Certification and Licensing:

• Refer to department description for applicable certification requirements

Experience:
Minimum 3 years of relevant experience required

Knowledge, Skills and Abilities:

• Learning Agility: Ability to learn new procedures, technologies, and protocols, and adapt to changing priorities and work demands.

• Teamwork: Ability to work collaboratively with others and contribute to a team environment.

• Technical Proficiency: Skilled in using office software, technology, and relevant computer applications.

• Communication: Strong and clear written and verbal communication skills for interacting with colleagues and stakeholders.

This is a core job profile description and is not reflective of all duties that may be assigned to a specific position in each individual department. The above statements are intended to describe the general nature and primary responsibilities of this core job profile. Specific duties and tasks may vary based upon departmental needs. Other duties may be assigned to the above consistent with the knowledge, skills, and abilities required for the job.

DEPARTMENT SPECIFIC JOB FUNCTIONS                                                                             

• Responsible for obtaining authorization for all elective scheduled procedures

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

• Obtains, confirms, and enters demographic, financial, and clinical information necessary for financial clearance of scheduled patient accounts.

• Working with physician nurse to complete spinal forms for insurance plans as necessary

• Obtaining CPT codes from Coder to submit authorization request

• Contacts patients’ families or physicians’ offices to obtain missing insurance information.

• Verifying insurance contracted with Physician and Facility

• Verifies insurance and confirms insurance eligibility and facility contracts of patient coverage benefits, notifying patient and referring physician in the event of failed eligibility.

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

• Collaborates with scheduling departments to identify add-on patients.