University of Miami Miller School of Medicine
Patient Benefits Advisor 2 (H) Full Time Bascom Palmer Eye Institute Miami, FL
University of Miami Miller School of Medicine, Miami, Florida, us, 33222
Patient Benefits Advisor 2 (H) – Full Time – Bascom Palmer Eye Institute, Miami, FL
The Patient Benefits Advisor 2 ensures that patients have adequate insurance coverage for services received and advises patients when there are any gaps in coverage so that appropriate payment arrangements can be made.
Core Job Functions
Greets every individual on the phone or in person with a smile and a warm, professional greeting.
Coordinates with the appropriate scheduling department to schedule patient appointments when prior authorizations have not been obtained or have been denied.
Assists departments with inquiries into the status of accounts, pre‑certification, eligibility, financial estimates, and department policies and procedures.
Ensures all patient information is secure and all paperwork disposed of appropriately to preserve confidentiality.
Ensures that prior authorizations are obtained and fully documented before the receipt of services.
Contacts physician offices to obtain missing patient information.
Utilizes patient estimate tools and insurance company contacts to obtain accurate out‑of‑pocket estimates, documents these estimates, and generates estimate letters.
Updates patient accounts as necessary with correct insurance information.
Submits insurance referral documentation in a timely fashion.
Adheres to University and unit-level policies and procedures and safeguards University assets.
Qualifications
High School diploma or equivalent.
Minimum 2 years of relevant experience.
Department Specific Functions
Reviews schedules and identifies patients who are uninsured/under‑insured and/or have previous balances.
Conducts comprehensive review of scheduled services, insurance coverages, previous balances, and payment history to create a detailed estimate.
Develops global packages for self‑pay patients/guarantors promptly within 1 to 3 business days to ensure compliance with CMS.
Serves as a patient benefit and financial advisor advocate by making outbound calls and/or meeting with patients and/or guarantors to educate them about costs, insurance coverage, and out‑of‑pocket costs, providing a detailed cost estimate.
Assists patient/guarantors in meeting their financial obligations by offering payment plans and/or identifying alternate payment sources prior to date of service.
Provides patients requesting financial assistance with a plain language summary, explains the process, and refers them to the MyChart website to complete a charity application and upload required documents.
Assigns financial assistance flag, creates/opens financial assistance case using the Financial Assistance Module, and uploads any documents provided by patient.
Processes credit card payments over the telephone in accordance with Payment Card Industry (PCI) security standards and monitors and follows up on pending deposits/payments.
Establishes and maintains effective collaborative working relationships with other departments, providers, insurance companies, and agencies to assist patient/guarantor in meeting financial obligations.
Provides statements in accordance with established policies and procedures.
Strives to meet or exceed established individual and departmental key performance indicator goals.
All collection efforts are clearly documented in system and provide follow-up of accounts until they are resolved.
Acts as a liaison and collaborates with the On‑site Pt. Access Team, CBO, and Clinical Departments in resolving any charge or previous outstanding balance discrepancies.
Trains new recruits in the Patient Benefit Advising team regarding procedures and systems and serves as a subject‑matter expert and resource to co‑workers and internal customers.
Performs other duties as assigned.
Benefits Competitive salaries and a comprehensive benefits package including medical, dental, tuition remission and more.
Employment Status
Full‑time
Employee Type: Staff
Pay Grade: H4
Equal Opportunity Statement The University of Miami is an Equal Opportunity Employer. Females, minorities, protected veterans, and individuals with disabilities are encouraged to apply. Applicants and employees are protected from discrimination based on categories protected by federal law.
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Core Job Functions
Greets every individual on the phone or in person with a smile and a warm, professional greeting.
Coordinates with the appropriate scheduling department to schedule patient appointments when prior authorizations have not been obtained or have been denied.
Assists departments with inquiries into the status of accounts, pre‑certification, eligibility, financial estimates, and department policies and procedures.
Ensures all patient information is secure and all paperwork disposed of appropriately to preserve confidentiality.
Ensures that prior authorizations are obtained and fully documented before the receipt of services.
Contacts physician offices to obtain missing patient information.
Utilizes patient estimate tools and insurance company contacts to obtain accurate out‑of‑pocket estimates, documents these estimates, and generates estimate letters.
Updates patient accounts as necessary with correct insurance information.
Submits insurance referral documentation in a timely fashion.
Adheres to University and unit-level policies and procedures and safeguards University assets.
Qualifications
High School diploma or equivalent.
Minimum 2 years of relevant experience.
Department Specific Functions
Reviews schedules and identifies patients who are uninsured/under‑insured and/or have previous balances.
Conducts comprehensive review of scheduled services, insurance coverages, previous balances, and payment history to create a detailed estimate.
Develops global packages for self‑pay patients/guarantors promptly within 1 to 3 business days to ensure compliance with CMS.
Serves as a patient benefit and financial advisor advocate by making outbound calls and/or meeting with patients and/or guarantors to educate them about costs, insurance coverage, and out‑of‑pocket costs, providing a detailed cost estimate.
Assists patient/guarantors in meeting their financial obligations by offering payment plans and/or identifying alternate payment sources prior to date of service.
Provides patients requesting financial assistance with a plain language summary, explains the process, and refers them to the MyChart website to complete a charity application and upload required documents.
Assigns financial assistance flag, creates/opens financial assistance case using the Financial Assistance Module, and uploads any documents provided by patient.
Processes credit card payments over the telephone in accordance with Payment Card Industry (PCI) security standards and monitors and follows up on pending deposits/payments.
Establishes and maintains effective collaborative working relationships with other departments, providers, insurance companies, and agencies to assist patient/guarantor in meeting financial obligations.
Provides statements in accordance with established policies and procedures.
Strives to meet or exceed established individual and departmental key performance indicator goals.
All collection efforts are clearly documented in system and provide follow-up of accounts until they are resolved.
Acts as a liaison and collaborates with the On‑site Pt. Access Team, CBO, and Clinical Departments in resolving any charge or previous outstanding balance discrepancies.
Trains new recruits in the Patient Benefit Advising team regarding procedures and systems and serves as a subject‑matter expert and resource to co‑workers and internal customers.
Performs other duties as assigned.
Benefits Competitive salaries and a comprehensive benefits package including medical, dental, tuition remission and more.
Employment Status
Full‑time
Employee Type: Staff
Pay Grade: H4
Equal Opportunity Statement The University of Miami is an Equal Opportunity Employer. Females, minorities, protected veterans, and individuals with disabilities are encouraged to apply. Applicants and employees are protected from discrimination based on categories protected by federal law.
#J-18808-Ljbffr