Patient Access Representative II

As Mount Sinai grows, so does our legacy in high-quality health care.

Since 1949, Mount Sinai Medical Center has remained committed to providing access to its diverse community. In delivering an unmatched level of clinical expertise, our medical center is committed to recruiting and training top healthcare workers from across the country. We offer the latest in advanced medicine, technology, and comfort in 12 facilities across Miami-Dade (including our 674-bed main campus facility) and Monroe Counties, with 38 medical services, including cancer care, 24/7 emergency care, orthopedics, cardiovascular care, and more. Mount Sinai takes pride in being South Florida's largest private independent not-for-profit hospital, dedicated to continuing the training of the next generation of medical pioneers.

Culture of Caring: The Sinai Way

Our hardworking, tight-knit community of more than 4,000 dedicated employees fosters an environment of care and compassion. Each member plays a vital role in our collective mission to deliver excellent healthcare through innovation, education, and research. At Mount Sinai, we take pride in our achievements, aiming to be a beacon of quality healthcare in South Florida. We welcome all healthcare professionals to join our thriving community and contribute to our pursuit for clinical excellence.

Department:
CC019039 Patient Access Hialeah West

Job Description Summary:

Schedule: 7a-730p x1, 7a-1130p x1, 7p-730a x1 = 40/HOURS WEEK
REQUIRED - bilingual in Spanish. Position Responsibilities

• Collects accurate and complete patient information (i.e.. legal name, permanent/local address, phone number, next of kin, employer, guarantor, insurance information, physician etc., and enters in the system within the established time frames.
• Verifies insurance information, which include eligibility, benefits (i.e.. Deductibles, co-payments, out of pocket expenses, maximum lifetime coverage, exclusion/limitations/pre-existing conditions, etc.) and obtains appropriate referrals, pre-certification, and/or authorizations for all patient as follows: scheduled patients no later that 24 hours. Unscheduled patients at point of service within the established time frames.
• Enters complete insurance verification information, which include eligibility, benefits (i.e.. Deductibles, co-payments, out of pocket expenses, maximum lifetime coverage, exclusion/limitations/pre-existing conditions, etc.) in the insurance verification screen and note fields.
• Ensures that a copy of insurance cards, front and back, as well as a copy of a picture ID is obtained and scannedat time patient presents for service.
• Provides and explains all registration documents (i.e.. General consent forms, Advance Directive information, Patient Rights information and Privacy Notice information.
• After completion of registration process ensures that an identification bracelet has been placed on all patients.
• After completion of registration process ensures all registration documents, as well as orders, accompany the patient to the appropriate area (i.e.. Nursing units, ancillary departments, etc.). Communicates all pertinent information regarding the patient to the appropriate departments patient care units.
• Prior to the end of shift conducts self-audit of all registration to insure that information is accurate and complete, maintaining less than 5% error ratio. Forwards copies to immediate supervisor with supportive information of incomplete tasks.
• Consistently demonstrates a clear understanding of departmental needs and job functions as assigned by department Manager and/or Team Leader.
• Demonstrates full knowledge of Compliance Advisor's functionality as it relates to Medicare Compliance and accurately enters diagnosis according to prescription to check for ABN compliance.
• Ensures that every registration has attached correct procedure, diagnosis (no R/O), printed physician's name and address on RX/referral and signature of doctor when indicated.
• Assists patient in understanding his/her insurance benefits and explains hospital financial and deposit policies including up front collections and follows established guidelines for up-front collections and collects and disburses revenue ensuring, at all times 100% accuracy of all ledgers and receipts, in accordance with established guidelines.
• Maintains compliance of Patient Access processes and Federal State and Local Laws and regulatory standards (ACHA, HIPPA, Medicare, Medicaid, EMTALA, COBRA, etc.).
• Demonstrates knowledge and proper use of HPF and QCI.
• Demonstrates knowledge and proper use of Avility Web MD and RTE applications.
• Demonstrates flexibility as well as ability to perform multiple functions within the Patient Access department.
• The individual is cross-trained to perform duties across various areas of areas assigned.
• Verifies authorizations for service.

Qualifications

• BILINGUAL IN SPANISH REQUIRED
• Education
  
  • High school graduate or equivalent level of training. Some college preferred
• Experience
  
  • One year practical experience in computer usage. Three years' practical experience in registration, collections and insurance verifications preferred.

Benefits:

We believe in the physical and mental well-being of our employees and are committed to offering comprehensive benefits that fit their personal needs:

• Health benefits
• Life insurance
• Long-term disability coverage
• Healthcare spending accounts
• Retirement plan
• Paid time off
• Pet Insurance
• Tuition reimbursement
• Employee assistance program
• Wellness program
• On-site housing for select positions and more!

Degree Requirements:

Certification: