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University of Massachusetts Amherst · 2 months ago

Departmental Assistant - Patient Benefit and Referral Specialist

Amherst, MA

Full-time

Onsite

Entry Level

$24/hr - $30/hr

3+ years exp

The University of Massachusetts Amherst is a nationally ranked public land-grant research university that seeks to expand educational access and fuel innovation. They are seeking a Departmental Assistant to manage the patient intake process, verify eligibility, and ensure timely access to care for patients at University Health Services.

EducationHigher EducationUniversities

Responsibilities

Accurately performs all functions related to the patient intake process by interviewing patients, verifying eligibility electronically via multi-payer systems and entering or update information in the practice manager in a timely manner and with a high degree of accuracy

Provides pre-determination of benefits and educates and informs patients about their responsibilities including co-pays and coordination of benefits

Addresses electronic eligibility alerts and contacts patients whose insurances are inactive with advance notice to be in compliance with the payer’s timely filing requirements

Collaborates with the Billing and Coding Departments for maximizing reimbursement of services provided

Provides patients with courteous, friendly, fast and efficient services

Maintains and demonstrates current knowledge of commercial insurances and requirements of plans accepted at UHS

Tracks outgoing referrals for completion and compliance, compiles data and prepares reports on a monthly basis

Schedules and manages routine and walk-in appointments for a multidisciplinary practice, adhering to the guidelines set forth by the providers

Processes referrals and orders accordingly, to specialist groups or outside imaging facilities. Additional consideration is required for a high-tech imaging request prior to the scheduling of a patient appointment

Reviews patient insurance plans to determine whether or not authorization is necessary, and if so, obtains authorization from the patient’s primary care provider or insurance company to facilitate patient care in-house and at specialist groups outside of UHS and receives proper reimbursement from the patient’s insurance plan

Manages incoming phone calls for all aspects of medical care including but not limited to appointments, prescription refills, test results and messages to providers

Prepares documentation and information pertinent to the patient’s appointment

Processes incoming referrals from outside primary care providers to allow patients to continue care at UHS while on campus. Reviews transaction codes to generate daily report to identify patients requiring an approval from their primary care provider. Contacts primary care provider and sends pertinent notes to obtain authorization, and once authorization is received, enters it into the practice manager for accurate reimbursement

Uses and manages systems to facilitate patient care at UHS, such as the Trext waiting system to alleviate patient wait times

Manages UHS Parkmobile system accurately to provide parking privileges to patients in the designated lot

Provides cross-coverage and back-up staffing support to other functions of the front-line staff, when needed

Maintains patient confidentiality at all times utilizing current HIPAA guidelines

Participates in annual UHS training and monthly departmental meetings to improve the quality of service provided to patients

Performs other duties as assigned

Qualification

Insurance verificationAuthorizationPredeterminationPractice management proficiencyElectronic health record (EHR)Medical terminologyCustomer service skillsMicrosoft ExcelTyping skillsCommunication skills

Required

Associate Degree from an accredited Medical Assistant Program or successful completion of certification as a Certified Medical Assistant, or high school diploma with at least 3 years of medical office experience

Prior experience with insurance verification, authorization and predetermination

Good oral and written communication skills including telephone etiquette

Knowledge of insurance plans; ability to understand and communicate detailed and complex health plan information to clientele

Practice management and electronic health record (EHR) proficiency

Excellent customer service skills and the ability to de-escalate front line customer service challenges

Ability to effectively communicate with colleagues, the public and other UHS staff

Strong computer, typing and oral communication skills, including telephone customer service skills

Experience working with Microsoft Excel or similar software

Working knowledge of basic hospital/clinic practice management and medical terminology