University of Miami Miller School of Medicine
Patient Access Representative 3 (On-Site) - Doral
University of Miami Miller School of Medicine, Miami, Florida, us, 33222
Patient Access Representative 3 (On-Site) - Doral
Overview
The University of Miami Health System at Doral has an exciting opportunity for a full-time Patient Access Representative 3 (On-Site) position. The role oversees registration and financial clearance activities to facilitate reimbursement for services and serves as a functional expert for department peers.
Core Responsibilities
Obtains, confirms, and enters demographic, financial, and clinical information necessary for financial clearance of scheduled patient accounts.
Contacts patientsamilies or physiciansorms offices to obtain missing insurance information.
Verifies insurance and confirms eligibility; notifies patient and referring physician when eligibility fails.
Collaborates with scheduling departments to identify add-on patients.
Obtains necessary authorizations, pre-certifications, and referrals.
Notifies patients of liabilities prior to the date of service and collects funds.
Maintains accurate records, files, and documentation in the system of record.
Serves as a lead resource for lower-level Patient Access Representatives.
Recommends new approaches to management for enhancing performance and productivity.
Adheres to University and unit-level policies and procedures and safeguards University assets.
Area Specific Functions
ER
Must possess a good understanding of the Emergency Room operations to proficiently support.
Proficient knowledge of ASAP module.
Flexible with rotating schedules including evenings, weekends, and holidays.
Able to perform ADT functions after hours, weekends, and holidays.
Adheres to PPE requirements as dictated by the situation.
Admitting
Understanding of Admitting operations to proficiently support the area.
Proficient knowledge of the ADT module.
On-call and rotating schedule for evenings, weekends, and holidays.
Explains and obtains patient acknowledgment for regulated documents (e.g., HIPAA forms, CMS notices).
Obtains information to complete Patient Self Determination Checklist and collects pertinent documents.
Responsible for eligibility and benefits documentation and health plan admission notification.
Maintains pre-admissions log including benefits, specialty, and financial clearance.
Coordinates with bed control on bed availability and collaborates with Transfer Center on transfers.
Processes admissions orders and coordinates with providers, nursing, and utilization review.
CTU
Must possess understanding of CTU operations to proficiently support the area.
Hospital Based Clinic
Must possess understanding of hospital-based department/clinic operations to proficiently support the area.
Practice Based Clinic
Must possess understanding of practice-based department/clinic operations to proficiently support the area.
Remote Based
Must possess understanding of remote call center operations to support Front-End Revenue Cycle and Clinical Support remote functions.
Core Qualifications
High school diploma or equivalent.
Minimum 3 years of relevant experience.
Knowledge of generally accepted accounting procedures and principles.
Ability to process and handle confidential information with discretion.
Ability to work independently and/or in a collaborative environment.
Excellent written and oral communication skills.
Tier 1 essential worker with critical functions in healthcare settings.
Ability to be available before opening and after clinic hours, including weekends, evenings, holidays, and disaster events when needed.
Ability to float and provide coverage across locations with little advance notice.
Onsite presence may be required as a vital part of healthcare delivery.
Knowledge of healthcare regulatory guidelines (OSHA, HIPAA, JC, AHCA, EMTALA, CMS).
Strong interpersonal and customer service skills and commitment to service excellence.
Excellent critical thinking, analytical, troubleshooting, and problem-solving skills.
Computer literate with proficiency in multiple systems and technology.
Ability to manage multiple tasks and adapt in a fast-paced environment.
Ability to work as part of a team with minimal supervision in a high-stress environment.
Ability to establish and maintain effective working relationships with physicians, staff, patients, and diverse backgrounds.
Adherence to punctuality and attendance standards and flexibility to meet departmental needs.
Note: Any appropriate combination of relevant education, HFMA certification, and experience may be considered. The University of Miami offers competitive salaries and a comprehensive benefits package.
EEO Statement
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 categories protected by Federal law.
Job Status: Full time
Employee Type: Staff
Pay Grade: H5
For reference, related roles include: Patient Access Associate 1, Patient Access Representative 2, Associate Administrator, and other Patient Access positions in the network.
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The University of Miami Health System at Doral has an exciting opportunity for a full-time Patient Access Representative 3 (On-Site) position. The role oversees registration and financial clearance activities to facilitate reimbursement for services and serves as a functional expert for department peers.
Core Responsibilities
Obtains, confirms, and enters demographic, financial, and clinical information necessary for financial clearance of scheduled patient accounts.
Contacts patientsamilies or physiciansorms offices to obtain missing insurance information.
Verifies insurance and confirms eligibility; notifies patient and referring physician when eligibility fails.
Collaborates with scheduling departments to identify add-on patients.
Obtains necessary authorizations, pre-certifications, and referrals.
Notifies patients of liabilities prior to the date of service and collects funds.
Maintains accurate records, files, and documentation in the system of record.
Serves as a lead resource for lower-level Patient Access Representatives.
Recommends new approaches to management for enhancing performance and productivity.
Adheres to University and unit-level policies and procedures and safeguards University assets.
Area Specific Functions
ER
Must possess a good understanding of the Emergency Room operations to proficiently support.
Proficient knowledge of ASAP module.
Flexible with rotating schedules including evenings, weekends, and holidays.
Able to perform ADT functions after hours, weekends, and holidays.
Adheres to PPE requirements as dictated by the situation.
Admitting
Understanding of Admitting operations to proficiently support the area.
Proficient knowledge of the ADT module.
On-call and rotating schedule for evenings, weekends, and holidays.
Explains and obtains patient acknowledgment for regulated documents (e.g., HIPAA forms, CMS notices).
Obtains information to complete Patient Self Determination Checklist and collects pertinent documents.
Responsible for eligibility and benefits documentation and health plan admission notification.
Maintains pre-admissions log including benefits, specialty, and financial clearance.
Coordinates with bed control on bed availability and collaborates with Transfer Center on transfers.
Processes admissions orders and coordinates with providers, nursing, and utilization review.
CTU
Must possess understanding of CTU operations to proficiently support the area.
Hospital Based Clinic
Must possess understanding of hospital-based department/clinic operations to proficiently support the area.
Practice Based Clinic
Must possess understanding of practice-based department/clinic operations to proficiently support the area.
Remote Based
Must possess understanding of remote call center operations to support Front-End Revenue Cycle and Clinical Support remote functions.
Core Qualifications
High school diploma or equivalent.
Minimum 3 years of relevant experience.
Knowledge of generally accepted accounting procedures and principles.
Ability to process and handle confidential information with discretion.
Ability to work independently and/or in a collaborative environment.
Excellent written and oral communication skills.
Tier 1 essential worker with critical functions in healthcare settings.
Ability to be available before opening and after clinic hours, including weekends, evenings, holidays, and disaster events when needed.
Ability to float and provide coverage across locations with little advance notice.
Onsite presence may be required as a vital part of healthcare delivery.
Knowledge of healthcare regulatory guidelines (OSHA, HIPAA, JC, AHCA, EMTALA, CMS).
Strong interpersonal and customer service skills and commitment to service excellence.
Excellent critical thinking, analytical, troubleshooting, and problem-solving skills.
Computer literate with proficiency in multiple systems and technology.
Ability to manage multiple tasks and adapt in a fast-paced environment.
Ability to work as part of a team with minimal supervision in a high-stress environment.
Ability to establish and maintain effective working relationships with physicians, staff, patients, and diverse backgrounds.
Adherence to punctuality and attendance standards and flexibility to meet departmental needs.
Note: Any appropriate combination of relevant education, HFMA certification, and experience may be considered. The University of Miami offers competitive salaries and a comprehensive benefits package.
EEO Statement
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 categories protected by Federal law.
Job Status: Full time
Employee Type: Staff
Pay Grade: H5
For reference, related roles include: Patient Access Associate 1, Patient Access Representative 2, Associate Administrator, and other Patient Access positions in the network.
#J-18808-Ljbffr