Sr. Patient Access Representative

Current Employees:

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 The University of Miami/UHealth Department Anesthesiology has an exciting opportunity for a full-time. Sr. Patient Access Representative to work in Miami, FL. The Sr. Patient Access Representative 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.

• Schedule Interventional procedures

• Procedure coding

• Medication Prior Authorizations

• Obtains necessary authorizations, pre-certifications, and referrals.

• Notifies patients of liabilities prior to date of service.

• 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

• Identify, process, and track procedure peer to peers

• Employee will process medication prior to authorizations

• Coordination with physicians for attorney conference calls and/or depositions

• Responsible for the completion of Worker’s Compensation DWC25 forms

• Scheduling and coding interventional procedures

• Review of clinical schedules (DAR)

• Create, submit, and follow up with Medication and interventional procedure appeals

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 equivalent

• Minimum 1 years of relevant experience

• 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.

Any relevant education, certifications and/or work experience may be considered.

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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 time

Employee Type:

Staff