Patient Access Representative 2 (On-Site) - Doral

Updated: about 1 month ago
Job Type: FullTime

Current Employees:

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The University of Miami Health System at Doral has an exciting opportunity for a full-time Patient Access Representative 2 (On-Site) with a hire date of June, 2024.

The University of Miami Health System will soon open the second phase to our state-of-the-art facility in Downtown Doral that serves as a western hub for our distinguished regional network of ambulatory services. This 160,000 square foot expansion will continue to bring world-class academic medicine, cutting-edge technology, and innovative treatment options to the rapidly growing Doral community.  UHealth at Doral will have services through the Sylvester Comprehensive Cancer Center, Bascom Palmer Eye Institute, and the Desai Sethi Urology Institute, as well as specialties such as cardiology, endocrinology, otolaryngology, gastroenterology, dermatology, and more. The expansion will provide residents with innovative, specialized medical services in the heart of their community.  Once complete, UHealth at Doral will have 8 operating rooms, 3 endoscopy procedure rooms, 33 cancer treatment bays, over 60 multidisciplinary exam rooms, and supporting ancillary services like imaging, lab, and respiratory therapy. UHealth at Doral will open in September, 2024.

The Patient Access Representative 2 (On-Site) registers patients for clinical services by obtaining pertinent information, verifying insurance benefits, explaining pertinent documents, and collecting payments.

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

Experience:

Minimum 2 years of relevant experience

Knowledge, Skills and Attitudes:

  • Knowledge of generally accepted accounting procedures and principles.

  • Skill in completing assignments accurately and with attention to detail.

  • Ability to process and handle confidential information with discretion.

  • Ability to work independently and/or in a collaborative environment.

  • Ability to communicate effectively in both oral and written form.

Department Specific Functions:

  • 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 that must be presented and thoroughly explained to the patient prior to services being rendered including but not limited to:  to Consent for Treatment and Conditions of Admissions, Advance Directives, HIPAA Notice of Privacy, No Surprise Billing, Good Faith Estimate, Off Campus Medicare Co-insurance and Advance Beneficiary Notices, and Medicare Secondary Payer Questionnaire. 

  • 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 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 Clinic:

    • 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. 

    Department Specific Qualifications:                                                                

    Education:

    High School diploma or equivalent 

    Experience:

    Minimum 2 years of relevant experience. 

      

    Any appropriate combination of relevant education, experience or certification may be considered. 

    A highly motivated individual with the ability to obtain HFMA Patient Access Essentials certification and satisfactorily demonstrate outstanding interpersonal skills with a commitment to service excellence and meeting departmental and individual goals may be considered. 

    Knowledge, Skills and Attitudes:

    • TIER 1 essential worker that provides critical functions that cannot be paused in traditional and non-traditional healthcare settings. 

    • Subject to potential contact/exposure to pandemics and patients with contagious diseases. 

    • Able to be available 30 minutes prior to opening and after clinic ends, which fluctuates depending on clinic and provider, in addition to weekends, evenings, holidays, and during disastrous events (e.g., hurricanes, pandemics, etc.) 

    • Able to float and provide coverage without advance notice based on daily organizational needs, including working in offsite locations, tents or having to come onsite if working remotely. 

    • Onsite presence may be required to fulfill role regarded as vital in the delivery of healthcare services regardless of environmental conditions. 

    • Knowledge of health care regulatory guidelines and compliance requirements including but not limited to: OSHA, HIPAA, JC, AHCA, EMTALA, and CMS. 

    • Outstanding interpersonal and customer service skills with a commitment to service excellence. 

    • Excellent critical thinking, analytical, troubleshooting, and problem-solving skills. 

    • Computer literate with the ability to acquire proficiency utilizing multiple systems and technology.  

    • Able to handle multiple tasks, software systems, and technologies simultaneously in a fast paced, constantly changing environment. 

    • Ability to work as an integral team member under minimal supervision, in a fast-paced, complex, and highly stressful environment. 

    • Knowledge of generally accepted accounting principles with excellent mathematical and cash management skills. 

    • Ability to establish and maintain effective working relationships with physicians, co-workers, other departments, and patients of all ages, and from across a broad range of cultural and social economic backgrounds. 

    • Skill in completing assignments accurately with attention to detail. 

    • Ability to work independently and/or in a collaborative environment.  

    • Adherence to punctuality and attendance standards, remaining flexible to meet departmental needs and ensure appropriate clinic flow. 

    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.

    Patient safety is a top priority. As a result, during the Influenza ("the flu") season (September through April), the University Of Miami Miller School Of Medicine requires all employees who provide ongoing services to patients, work in a location (all Hospitals and clinics) where patient care is provided, or work in patient care or clinical care areas, to have an annual influenza vaccination. Failure to meet this requirement will result in rescinding or termination of employment.

    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 certain categories protected by Federal law. Click here for additional information.

    Job Status:

    Full time

    Employee Type:

    Staff

    Pay Grade:

    H4

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