Patient Access Representative 3 (On-Site) (H)

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 upstream. 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 currency and performs end of day cash-drawer reconciliation and timely bank deposits. Assists department in meeting all established key performance indicator goals: Co-pay, Previous Balances, Estimate Collections, Patient Satisfaction, Accuracy Rates, and Processing Time.

Maintains a close working relationship and open communication with all members of the healthcare team to ensure a seamless check in, check out, clinic flow and positive experience for patients and caregivers. Recognize, analyze, solve, and de-escalate issues that may arise during workday by applying sound judgement and critical thinking. Ensures proper physical distancing is always maintained following established guidelines. Works with healthcare team to resolve unique situations and troubleshoot issues.

Cross trained to carry out all Front-End Revenue Cycle and Clinical Support functions and able to float across all areas and assist as needed. Knowledge of health care regulatory guidelines and compliance requirements including but not limited to: OSHA, HIPAA, JC, AHCA, EMTALA, and CMS.

AREA SPECIFIC ER

Must possess a good understanding of the unique characteristics and operations of the Emergency Room to proficiently support. Proficient knowledge of ASAP module. Must be flexible and adjust to rotating schedules evenings, weekends, and holidays. Able to perform ADT functions (as described under Admitting section) afterhours, weekends, and holidays. Must adhere to PPE requirements as dictated by the specific situation.

ADMITTING

Must possess a good understanding of the unique characteristics and operations of Admitting to proficiently support the area. Proficient knowledge of ADT module. On-call and rotating schedule for evenings, weekends, and holidays. Explains and obtains patient acknowledgment for all required regulatory documents including but not limited to the HIPAA Facility Directory Form, and CMS MOON, HOON, and IMM notices. Obtains information from patient to complete Patient Self Determination Checklist and collects and scans pertinent documents.

Responsible for obtaining, confirming, and documenting eligibility and benefits, and providing health plan admission notification. Responsible for pre-admissions log to include benefits, specialty, and financial clearance. Coordinates with bed control on bed availability. Collaborates with Transfer Center on all incoming transfers to finalize transfer requests. Responsible for processing admissions orders received via in-basket messaging. Extensive collaboration with providers, nursing unit, and utilization review department in coordinating admissions.

CTU

Must possess a good understanding of the unique characteristics and operations of CTU to proficiently support the area.

HOSPITAL BASED CLINIC

Must possess a good understanding of the unique characteristics and operations of the hospital-based department/clinic/division to proficiently support the area.

PRACTICE BASED CLINIC

Must possess a good understanding of the unique characteristics and operations of the practice-based department/clinic/division to proficiently support the area.

REMOTE BASED

Must possess a good understanding of the unique characteristics and operations of remote based call center operations to proficiently support all Front-End Revenue Cycle and Clinical Support remote functions. 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

High School Diploma or equivalentMinimum 3 years of relevant experience requiredKnowledge, 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. Any relevant education, certifications and/or work experience may be considered.

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.

The University of Miami is an Equal Opportunity Employer. Applicants and employees are protected from discrimination based on certain categories protected by Federal law.

Job Status: Full timeEmployee Type: Staff

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Common Interview Questions And Answers

1. HOW DO YOU PLAN YOUR DAY?

This is what this question poses: When do you focus and start working seriously? What are the hours you work optimally? Are you a night owl? A morning bird? Remote teams can be made up of people working on different shifts and around the world, so you won't necessarily be stuck in the 9-5 schedule if it's not for you...

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When you're working on a remote team, there's no way to chat in the hallway between meetings or catch up on the latest project during an office carpool. Therefore, virtual communication will be absolutely essential to get your work done...

3. WHAT IS "WORKING REMOTE" REALLY FOR YOU?

Many people want to work remotely because of the flexibility it allows. You can work anywhere and at any time of the day...

4. WHAT DO YOU NEED IN YOUR PHYSICAL WORKSPACE TO SUCCEED IN YOUR WORK?

With this question, companies are looking to see what equipment they may need to provide you with and to verify how aware you are of what remote working could mean for you physically and logistically...

5. HOW DO YOU PROCESS INFORMATION?

Several years ago, I was working in a team to plan a big event. My supervisor made us all work as a team before the big day. One of our activities has been to find out how each of us processes information...

6. HOW DO YOU MANAGE THE CALENDAR AND THE PROGRAM? WHICH APPLICATIONS / SYSTEM DO YOU USE?

Or you may receive even more specific questions, such as: What's on your calendar? Do you plan blocks of time to do certain types of work? Do you have an open calendar that everyone can see?...

7. HOW DO YOU ORGANIZE FILES, LINKS, AND TABS ON YOUR COMPUTER?

Just like your schedule, how you track files and other information is very important. After all, everything is digital!...

8. HOW TO PRIORITIZE WORK?

The day I watched Marie Forleo's film separating the important from the urgent, my life changed. Not all remote jobs start fast, but most of them are...

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This is a great question because it shows your comfort level with technology, which is very important for a remote worker because you will be working with technology over time...

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