Lead Surgery Services Representative- Full Time Bascom Palmer Eye Institute, Miami, FL

Lead Surgery Services Representative position in the Department of Patient Access at the University of Miami, Bascom Palmer Eye Institute in Miami, Florida.

About the role

Coordinates complex surgery scheduling and front-end revenue cycle clinic functions that impact the patient experience, surgical volume, and revenue. Serves as a functional expert for department peers and oversees team adherence with established policies and procedures.

Responsibilities

• Obtains, confirms, and enters demographic, financial, and clinical information necessary for financial clearance of scheduled patient accounts.
• Monitors cancellations to maintain schedules and quickly identify and fill cancelled slots to mitigate decreased provider productivity and loss of revenue.
• Contacts patients’ families or physicians’ offices to obtain missing insurance information.
• Verifies insurance and confirms insurance eligibility of patient coverage benefits, notifying patient and referring physician in the event of failed eligibility.
• Creates a patient identification band for each patient in accordance with patient safety and risk management protocols and validates information when placing the band.
• Collaborates with scheduling departments to identify add-on patients.
• Creates estimates for both hospital and professional fees.
• Obtains necessary authorizations, pre-certifications, and referrals.
• Notifies patients of liabilities prior to date of service and collects funds.
• Maintains appropriate records, files, and accurate documentation in the system of record.
• Serves as a lead resource for lower-level Patient Services staff and assists with training.
• Recommends new approaches to management for enhancing performance and productivity.
• Deploys critical thinking while responding to a variety of technical issues from patients, physicians, and employees via phone, email, web messages, fax, or email.
• Works independently and deals effectively with stress due to heavy workload and handling of complex patient inquiries.
• Serves as a role model, facilitator, and coach in developing a culture of compassion and caring through building healthy relationships among staff, patients, and families.
• Projects a professional appearance and pleasant demeanor creating a welcoming atmosphere.
• Adheres to University and unit-level policies and procedures and safeguards University assets.
• Establishes and maintains a close collaborative working relationship and open communication with providers, support clinical team, and patients.
• Coordinates and schedules all pre-operative and post-operative visits, and surgical procedures promptly in the system in accordance with complex specialty provider instructions.
• Validates patient identification by obtaining pertinent documents and verifying identity by using two main identifiers, and scanning documents into system.
• Interviews patients and verifies demographic and financial registration data in electronic system and makes appropriate changes as necessary including insurance coverage information.
• Conducts critical communication with patients and legal guardian facilitating the understanding of and obtaining signature on legal, ethical, and compliance-related documents.
• Ensures all required documents, consents, implants, or tissues are available prior to procedure.
• Verifies insurance information, obtains benefits, and determines financial classification.
• Reviews and identifies discrepancies in auto-generated estimates and creates accurate detailed hospital and professional estimates as needed.
• Explains insurance benefits/coverages, global/flat fee options, and collects co-payments, deductibles, co-insurance, and non-covered amounts for both hospital & professional fees prior to surgery.
• Promptly works all bypass warnings, registration work queues, and Medicare Secondary Payer Questionnaire, if applicable.
• Confirms that Consent for Surgery has been signed by patient and provider and procedure listed is validated against surgery schedule, follows up if necessary.
• Reviews and follows up with appropriate departments to ensure that all pre-op results are available prior to the procedure.
• Orders, creates purchase orders, and keeps track of implants or tissues needed from external vendors, as needed.
• Arranges for bed assignment or transfer, if applicable.
• Works with healthcare team to resolve unique situations and troubleshoot issues.
• Meets established individual and departmental key performance indicator goals: Co-pay, Previous Balances, Estimate Collections, Patient Satisfaction, Accuracy Rates, and Processing Time.
• Responds to and resolves complex scheduling and billing inquiries, and patient grievances.
• Cancels and reschedules all visits and surgeries as needed due to Provider Call Outs or weather conditions.
• Cross-trained and able to float and cover other surgery specialties.
• Serves as subject matter expert resource to Surgery Services Representatives and assists with training and supervision.

Requirements

• High school diploma or equivalent required.
• Minimum 3 years of relevant experience.
• Skilled in data entry and completing assignments accurately and with attention to detail.
• Skilled in prioritizing and organizing tasks.
• Ability to communicate effectively in both oral and written form.
• Ability to process and handle confidential information with discretion.
• Ability to work independently and/or in a collaborative environment.
• Ability to analyze, organize, and prioritize work under pressure while meeting multiple deadlines.
• Ability to handle multiple tasks, software systems, and technologies simultaneously.
• Ability to establish and maintain effective working relationships with patients and staff.
• Knowledge of generally accepted accounting procedures and principles.
• Works well under unstructured work environments/processes.
• Flexible with shifts on day-to-day tasks and responsibilities.
• Able to switch rapidly between different tasks effectively.
• Adaptable to new responsibilities.
• Handles distractions well.
• Manages large call volume daily (30+ calls).
• Proficiency in computer software (i.e., Microsoft Office).

Benefits

• Competitive salaries.
• Comprehensive benefits package including medical and dental.
• Tuition remission.