Patient Access Representative

About the Role

Join Mount Sinai Medical Center, South Florida's largest private independent not-for-profit hospital, as we expand our legacy in high-quality healthcare. This role is based at our new Mount Sinai Westchester facility, focusing on accurate and timely patient pre-registration.

Responsibilities

• Collects accurate and complete patient information (e.g., legal name, address, phone number, next of kin, employer, guarantor, insurance details, physician) and enters it into the system within established time frames.
• Verifies insurance information, including eligibility, benefits (deductibles, co-payments, out-of-pocket expenses, maximum lifetime coverage, exclusions/limitations/pre-existing conditions), and obtains referrals, pre-certification, or authorizations for all patients:
  • Scheduled patients: no later than 24 hours prior to service.
  • Unscheduled patients: at the point of service within established time frames.
• Enters complete insurance verification information into the system, including eligibility and benefits details.
• Obtains and scans copies of insurance cards (front and back) and a picture ID at the time the patient presents for service.
• Provides and explains registration documents (e.g., general consent forms, Advance Directive information, Patient Rights, and Privacy Notice).
• Ensures an identification bracelet is placed on all patients after registration.
• Ensures all registration documents and orders accompany the patient to the appropriate area (e.g., nursing units, ancillary departments).
• Communicates pertinent patient information to appropriate departments and patient care units.
• Conducts a self-audit of all registrations before the end of the shift to ensure accuracy and completeness, maintaining less than a 5% error ratio. Forwards incomplete tasks to the immediate supervisor with supportive information.
• Demonstrates a clear understanding of departmental needs and job functions as assigned by the department Manager and/or Team Leader.
• Demonstrates full knowledge of Compliance Advisor’s functionality related to Medicare Compliance and accurately enters diagnoses according to prescriptions to check for ABN compliance.
• Ensures every registration includes the correct procedure, diagnosis (no R/O), printed physician’s name and address on RX/referral, and the doctor’s signature when indicated.
• Assists patients in understanding their insurance benefits and explains hospital financial and deposit policies, including up-front collections. Follows established guidelines for up-front collections and ensures 100% accuracy of all ledgers and receipts.
• Maintains compliance with Patient Access processes and Federal, State, and Local laws and regulatory standards (e.g., ACHA, HIPAA, Medicare, Medicaid, EMTALA, COBRA).
• Demonstrates knowledge and proper use of RMS scheduling program, HPF, QCI, Avility Web MD, and RTE applications.
• Demonstrates flexibility and the ability to perform multiple functions within the Patient Access department, including cross-training across various assigned areas.
• Verifies authorizations for service.

Requirements

• Bilingual in Spanish (required).
• High school graduate or equivalent level of training; some college preferred.
• 1–3 years of practical experience in registration, collections, and insurance verifications, preferably in a hospital or physician office front desk setting.
• Strong attention to detail and ability to work in a fast-paced ER environment.

Benefits

Mount Sinai offers comprehensive benefits tailored to support the physical and mental well-being of our employees:

• Health benefits
• Life insurance
• Long-term disability coverage
• Healthcare spending accounts
• Retirement plan
• Paid time off
• Pet insurance
• Tuition reimbursement
• Employee assistance program
• Wellness program
• On-site housing for select positions

Schedule

Monday to Friday, 8:30 AM – 5:00 PM, with weekends as needed.