Sr. Patient Access Representative

Sr. Patient Access Representative

The University of Miami is currently seeking a Sr. Patient Access Representative. The incumbent oversees pre-registration and clearance activities and serves as functional expert for department peers. Further, the Sr. Patient Access Representative assumes responsibility for documenting all necessary data that will facilitate reimbursement for services rendered by the department.

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.
• Recommends new approaches to management for enhancing performance and productivity.
• 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.

Department Specific Functions

• Performs full registration ensuring insurance is verified and all information is correct.
• Verifies patient demographic, insurance information for accuracy and edits information as necessary.
• Obtains copies of insurance cards, pertinent documents, and medical records when applicable.
• Assures all demographic insurance information is accurate, complete and up to date on patient's screen.
• Requests medical records.
• Creates case guarantor case type.
• Assigns and logs patient cases to coordinators.
• Manages UHealth International inbox inquiries and distributes appropriately.
• Prioritizes cases and volume of inquiries.
• Manages and troubleshoots patient complaints.
• Handles and routes all incoming calls to respective task buckets and personnel.
• Determines the appropriate questionnaires and forms to instruct patient to complete.
• Sends duplicate accounts for merging.
• Maintains different operational logs and metrics.
• Distribute and log agreements.
• Scan pertinent medical records and completed agreements/Letter of agreements (LOG) into EPIC.
• Schedules appointments for International Medical Director.
• Multitasks and priorities cases as appropriate.
• Answer incoming telephone calls.
• Performs other duties as assigned

Core Qualifications

Education: High School diploma or equivalent

Experience: Minimum 3 years of relevant experience

The University of Miami offers competitive salaries and a comprehensive benefits package including medical, dental, tuition remission and more.