Sr Patient Accounts Representative H
Sr Patient Accounts Representative H
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Job Description
Current Employees:
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The University of Miami/UHealth Department of Neurological Surgery is currently seeking a full time 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 research issues and provides written responses.
Enters all returned mail and stale checks in the database and research to acquire updated address information to reprocess items.
Recommends policy and procedural changes to management for review as needed.
Adheres to University and unitlevel policies and procedures and safeguards University assets.
This list of duties and responsibilities is not intended to be allinclusive and may be expanded to include other duties or responsibilities as necessary.
CORE QUALIFICATIONS
Education:
High School diploma or equivalent required
Experience:
Minimum of 3 years of relevant experience required
Knowledge Skills and Attitudes:
Skill in completing assignments accurately and with attention to detail
Ability to analyze organize and prioritize work under pressure while meeting deadlines.
Ability to process and handle confidential information with discretion.
Proficiency in computer software (i.e. Microsoft Office).
Ability to communicate effectively in both oral and written form.
Department Specific Functions
Responsible for obtaining authorization for all elective scheduled procedures
Obtains necessary authorizations precertifications 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 addon patients.
Deploys critical thinking while responding to a variety of technical issues from patients physicians and employees via phone email web messages fax or email.
Works independently and deals effectively with stress due to heavy workload and the handling of complex patient inquiries.
Recommends new approaches to management for enhancing performance and productivity.
Ability to communicate effectively in both oral and written form.
Ability to process and handle confidential information with discretion.
Ability to analyze organize and prioritize work under pressure while meeting deadlines
Outstanding interpersonal skills with a commitment to service excellence.
Able to handle multiple tasks software systems and technologies simultaneously.
Notifying patient of financial responsibility (out of pocket deductible coinsurance)
Requesting Single Case Negotiation letters from 2nd party once out of network auth is approved
Working in conjunction with PCPs office in obtaining referrals/ authorization
Update Insurance information in UChart in a timely manner.
Submit/Communicate with 3rd party vendors by sending approvals to the corresponding facility.
Working with international and domestic selfpay teams in requesting quotes
Work with Physician Nurse Liaison and Administrative Assistant to appeal any denial or Peer to Peer review to ensure all procedures are authorized prior to date of service.
Set up peer to peer with healthplan
Notifying physician of denials
Notifying patients of denial or pending cases >3 days prior to surgery
Prepare surgical package for Billing with all pertinent information including authorization
Ability to establish and maintain effective working relationships with patients and staff.
Attend staff meetings
Answers the phone in a prompt and courteous manner relaying messages accurately and timely.
Other duties as assigned
#EDLI1
The University of Miami offers competitive salaries and a comprehensive benefits package including medical dental tuition remission and more.
UHealthUniversity of Miami Health System South Floridas only universitybased health system provides leadingedge 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 subspecialties 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. Were the challenge youve been looking for.
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 timeEmployee Type:
StaffPay Grade:
H4Required Experience:
Senior IC
Employment Type
Full-Time
