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The University of Miami is among the top research universities and academic medical centers in the nation, and one of the largest private employers in South Florida.
With more than 16,000 faculty and staff, the University strives for excellence, and is driven by a powerful mission to transform and impact the lives of its students, patients, members of the community, and people across the globe.
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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
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.
Patient safety is a top priority. As a result, during the Influenza ("the flu") season (September through April), the University Of Miami Miller School Of Medicine requires all employees who provide ongoing services to patients, work in a location (all Hospitals and clinics) where patient care is provided, or work in patient care or clinical care areas, to have an annual influenza vaccination. Failure to meet this requirement will result in rescinding or termination of employment.
The University of Miami is an Equal Opportunity Employer - Females/Minorities/Protected Veterans/Individuals with Disabilities are encouraged to apply. Applicants and employees are protected from discrimination based on certain categories protected by Federal law. Click here for additional information.
Job Status:Full time