Patient Benefits Advisor 2

Current Employees:

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The University of Miami, Bascom Palmer Eye Institute, has an exciting full time opportunity for a Patients Benefits Advisor 2 in Miami, Florida.

The Patient Benefits Advisor 2 ensures that patients have adequate insurance coverage for services received and advises patients when there are any gaps in coverage so that appropriate payment arrangements can be made.

Core Job Functions:

• Greets every individual on the phone or in person with a smile and a warm, professional greeting.
• Coordinates with appropriate scheduling department to schedule patient appointments when prior authorizations have not been obtained or have been denied.
• Assists departments with inquiries into the status of accounts, pre-certification, eligibility, financial estimatesand department policies and procedures.
• Ensures all patient information is secure and all paperwork disposed of appropriately to preserve confidentiality.
• Ensures that prior authorizations are obtained and fully documented prior to the receipt of services.
• Contacts physician offices to obtain missing patient information.
• Utilizes patient estimate tools and insurance company contacts to obtain accurate out-of-pocket estimates, documents these estimates, and generates estimate letters.
• Updates patient accounts as necessary with correct insurance information.
• Submits insurance referral documentation in a timely fashion.
• Adheres to University and unit-level policies and procedures and safeguards University assets.
  

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
Education:
High School diploma or equivalent
Certification and Licensing:
Not Applicable
Experience:
Minimum 2 years of relevant experience

Knowledge, Skills and Attitudes:
• Strong customer service skills
• Strong written and verbal communication skills
• Highly detail oriented and organized
• Excellent interpersonal skills
• Knowledge of medical terminology

DEPARTMENT ADDENDUM

Department Specific Functions

* Reviews schedules and identifies patients who are uninsured/under-insured and/or have previous balances.
* Conducts comprehensive review of scheduled services, insurance coverages, previous balances, and payment history and creates a detailed estimate.
* Develops global packages for self-pay patients/guarantors promptly within 1 to 3 business days to ensure compliance with CMS.
* Serves as a patient benefit and financial advisor advocate by making outbound calls and/or meeting with patients and/or guarantors to educate and facilitate their understanding of the costs associated with the health care services they need, how much their insurance covers and what will be their out of pocket costs and provides them with a detailed estimate of costs.
*Assists patient/guarantors in meeting their financial obligations by offering payment plans and/or identifying alternate payment sources prior to date of service to patients requesting financial assistance.
*Provides patients requesting financial assistance with plain language summary, explains process, and refers them to MyChart website to complete charity application and uploading of required documents.
* Assigns financial assistance flag, creates/opens financial assistance case using Financial Assistance Module, and uploads any documents provided by patient.
* Processes credit card payments made over the telephone in accordance with Payment Card Industry (PCI) security standards and monitors and follows up on pending deposits/payments.
* Establishes and maintains effective collaborative working relationships with other departments, providers, insurance companies, federal, state, or local agencies to assist patient/guarantor in meeting financial obligations.
* Provides statements in accordance with established policies and procedures.
* Strives to meet or exceed established individual and departmental key performance indicator goals.
* All collection efforts are clearly documented in system and provides follow-up of accounts until they are resolved.
* Acts as a liaison and collaborates with the On-site Pt. Access Team, CBO, and Clinical Departments in resolving any charge or previous outstanding balance discrepancies.
* Trains new recruits in the Patient Benefit Advising team regarding procedures and systems and is the Subject Expert Matter and a resource to co-workers and internal customers.
* Performs other duties as assigned.
 

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.

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