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PATIENT ACCESS REP

Mount Sinai Medical Center. – Miami Beach, FL

As Mount Sinai continues to grow. so does our legacy of caring.

Mount Sinai Medical Center is proud to be South Florida s hospital of choice for great medicine. With more than 4000 employees. 500 volunteers. 670 beds. 26 operating suites and more than 650 physicians and 950 nurses. Mount Sinai is South Florida s largest private independent not-for-profit teaching hospital.

It takes the contribution of many individuals to make Mount Sinai the world-class institution it is today. As a team. we have focused our efforts on assuring that our patients receive high quality medical care. We re looking for motivated professionals who seek the challenge and stimulation of working in an academic medical center with an international reputation.

We offer:

  • An excellent. team focused work environment with opportunity for professional growth
  • Competitive salary with bonus potential
  • Savings plan with company match
  • A variety of health. dental and vision plans
  • On-site childcare. tuition reimbursement. and much more!

Duties:

  • Collects accurate and complete patient information (i.e.. legal name permanent/local address phone number next of kin employer guarantor insurance information physician etc. and enters in the system within the established time frames.
  • Verifies and enters completed insurance information which includes eligibility benefits (i.e.. Deductibles co-payments out of pocket expenses maximum lifetime coverage exclusion/limitations/pre-existing conditions etc.) in the insurance verification screen and note fields and obtains appropriate referrals pre-certification and/or authorizations for all patient as follows: scheduled patients no later that 24 hours. Unscheduled patients at point of service within the established time frames.
  • Ensures that a copy of insurance cards front and back as well as a copy of a picture ID is obtained and scanned.
  • After completion of registration process ensures that an identification bracelet has been placed on all patients. Before placing I.D. bracelet confirm patient Name and Date of Birth.
  • Insures all patients are rebanded with the inpatient armbands when information is provided by bed control. Before rebanding check the I.D. bracelet to insure patient name DOB and physician is correct.
  • Provide and explain all registration documents (i.e.. General consent forms Advance Directive information Patient Rights information and Privacy Notice information billing and financial information.
  • After completion of registration process ensures all registration documents as well as orders accompany the patient to the appropriate area (i.e.. Nursing units ancillary departments etc.). Communicates all pertinent information regarding the patient to the appropriate departments patient care units.
  • Prior to the end of shift conducts self-audit of all registration to insure that information is accurate and complete maintaining less than 5% error ratio. Assisting to maintain the Patient Access monthly audit goal of 100%. Audit includes opt out information correct insurance plans authorization ID numbers Patient Types Duplicate Medical Record Numbers ACHA and MSP information.
  • Consistently demonstrates a clear understanding of departmental needs and job functions as assigned by department Manager and/or Team Leader Supervisor.
  • Demonstrates full knowledge of Compliance Advisor s functionality as it relates to Medicare Compliance and accurately enters diagnosis according to prescription to check for ABN compliance. complete all MSP fields for Medicare compliance
  • Insure that every registration has attached correct procedure diagnosis (noR/O) printed physician s name and address on RX/referral and signature of doctor when indicated.
  • Assist patient in understanding his/her insurance benefits and explains hospital financial and deposit policies including up front collections and follows established guidelines for up-front collections and collects and disburses revenue ensuring at all times 100% accuracy of all ledgers and receipts in accordance with established guidelines.
  • Maintains compliance of Patient Access processes and Federal State and Local Laws and regulatory standards (ACHA HIPPA Medicare Medicaid EMTALA COBRA etc.).
  • Demonstrates knowledge to view scheduling programs.
  • Reviews HPF QCI and account before calling the physician office or ask patient for a prescription. Notifies Team Leader or Manager on pending prescriptions at lease 24 hours prior to appointment time.
  • Demonstrates knowledge and proper use of Avility Web MD and RTE applications.
  • Print and review the emergency department EQA/EQB worklist every 15/30 minutes to maintain accurate registration times and also to insure all patients who have been triaged and registered.
  • Insure that every registration has attached the correct prescription for procedure diagnosis (no R/O) hospital name printed physician s name address on RX/referral and signature of physician.
  • Pre-Registers 100% of patients scheduled no later than 24 hours prior to date of service.
  • Ensures that scheduled patients are called and given travel preparation and insurance information before visit date.
  • Verifies all non-staff physician against OIG list online.
  • Ensures appropriate personnel are aware of onscheduled patients and or add-ons.
  • Consistently demonstrate a clear understanding of departmental needs and job functions as assigned by department manager and team leaders.
  • Report incomplete task to immediate supervisor.
  • Follow cash collection and cash receipts journal policy.
  • Insure valuables are deposited and/or retrieved in accordance with the valuables hospital policy.

    Minimum Requirements:

  • One year practical experience in computer usage.
  • One year prior experience in registration collections and insurance verifications preferred. Excellent communication and customer service skills.
  • High school graduate or equivalent level of training. Some college preferred

Minimum Requirements:

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