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|Patient Accounts 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
Patient Accounts Representative|
The Department of Surgery is currently seeking a Patient Accounts Representative. The Patient Accounts Representative coordinates functions of collections and customer service on the individual patient account.
CORE JOB FUNCTIONS
Responds to patient or guarantor inquiries on the status of accounts and explains accounts, while making all necessary efforts to collect payment in compliance with policies and procedures. Processes payments over the phone and when unable to obtain payment follows up on account until payment is received.
Sets up budget plans on outstanding accounts, mails copy of agreements to patients, and reviews plans for compliance.
Follows-up on defaulted agreements with a call or letter and monitors plan until default is resolved.
Reviews on a daily basis all patient, insurance company, and attorney correspondence, researches any issues, and provides written response.
Assists in balancing monthly cash clearing account.
Enters all returned mail and stale check information into the search database, and acquires updated address information to reprocess returned mail and stale checks.
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 1 of relevant experience required