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|Sr. Patient Account Representative|
Company: University of Miami Health System
Location: Miami, FL
Employment Type: Full Time
Date Posted: 10/15/2021
Expire Date: 12/15/2021
Job Categories: Administrative and Support Services
Sr. Patient Account Representative|
The Department of Surgery is currently seeking a Sr. Patient Accounts Representative. 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, researches issues, and provides written responses.
Enters all returned mail and stale checks in the database and researches to acquire updated address information to reprocess items.
Recommends policy and procedural changes to management for review as needed.
Adheres to University and unit-level policies and procedures and safeguards University assets.
Perform insurance verifications for Transplant patients to provide and maintain financial clearance throughout the Transplant process including referral, evaluation, listing, transplant, and post-transplant related care. Update all systems including OTTR, UChart, Cerner, and others as needed. Communicate with patients on accounts or for deposits as needed.
Review Surgeon, Physician and ARNP charges entered for appropriate diagnosis and procedure coding, levels of care, and modifiers to ensure accurate and complete charge capture in MCSL. Follow up to ensure charges are filed in UChart. Follow up with Physicians and staff for non-captured surgical, inpatient, outpatient, and procedure services.
Create UChart Cases as needed for Transplant bundled payers, SCN’s, and Kidney Acquisition Fund. Monitor Transplant WQ’s including bundled payers, SCN’s and Kidney Acquisition Fund daily ensuring timely linking and release of charges based on diagnosis, procedure, referring physicians and medical necessity.
Participate in special projects such as Optum/URN online, the Transplant Global Medicaid Bundled program, the Referring Physician Letter Project, or out of state Medicaid Credentialing Packages.
Review for medical record documentation as needed for charge entry, collections, or appeals for inpatient, outpatient, or surgical care. Follow up with physicians and staff as needed.
Research and use problem solving skills to resolve issues from the collections offices regarding denials, appeals, and cases until resolved.
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.
High School diploma or equivalent required
Minimum of 3 years of relevant experience required