Obtain accurate and detailed demographic, financial, and clinical information in order to perform accurate and complete registrations/admissions, while exhibiting warmth, compassion, and responsiveness to patients, their families and friends, professionals, and co-workers within the health system. Under supervision, registers patients at times in a fast paced environment, registering patients within (15) minutes; allowing efficient patient throughput in order to meet patient throughput and patient satisfaction goals. Queries EAD and enters accurate patient demographics into the computer system to obtain the correct patient medical record number and account number. Registers patients by verifying the demographic and insurance information is accurate and up to date. Makes necessary changes in the computer system. All required registration forms are to be accurate and completed during the registration process.
Responsible for placing patient identification armbands on all patients after accounts are created, in order to ensure patient safety. Greets all customers (patients, guest, families, staff, physicians, vendors, etc.) in a helpful and courteous manner while extending exemplary customer service. Anticipates and responds to inquiries and needs in an assertive, yet courteous manner. Performs insurance eligibility/benefit verification, utilizing an EDI transaction and documenting information within the appropriate registration system. Obtains prior authorizations for those payers that require pre-authorization for outpatient and/or diagnostic services. Validates medical necessity (LMRP/LCD review) of Medicare and Non-Medicare cases to ensure clinical and financial clearance. Contacts physicians/office staff for clarification, if cases require clarification of diagnosis and/or test(s)/procedure(s). Obtains ABN’s as necessary. Obtains physician orders to support services rendered. Order ancillary tests within the order entry system. Monitors and coordinates patient placement through bed control functions in a timely and patient focused manner. Informs patient/guarantor of their liabilities and collects appropriate patient co-payments, co-insurances, deductibles, and deposits at the point of discharge. Calculates patient liabilities and provides financial education. Provides the patient with a payment receipt. Answer telephone inquiries. Assists insurance companies, physician and physician practices, and other hospital departments with patient information in accordance with HIPAA guidelines. Meets or exceeds accuracy standard goal determined by Patient Access Leadership; Ensures integrity of patient accounts by working error reports daily, entering accurate data, and documenting all attempts made to collect and or obtain missing documentation.
Education Requirements
High school diploma required. College courses in Business, Medical Office Administration, Health Care Administration,
and/or Computer Technology preferred.
Minimum Experience, Knowledge, Skill, and Ability Requirements
One to two years (1-2) insurance/clerical experience within a hospital or medical office setting preferred. Knowledge of insurance and collection of payments preferred. Experience with Microsoft windows required along with knowledge of basic functionality of personal computer. Ability to type and perform data entry functions at a level required and needed to maintain productivity standards of a department. Excellent verbal and written communication skills are required. Demonstrated customer service skills to a variety of customers from different cultural and economic backgrounds preferred. Critical thinking skills and ability to problem solve and multi-task required. Must be multi-skilled with the ability to appropriately handle complexity and stress with the changing needs of the patients, families, visitors, and the Health System. May be required to periodically rotate shifts and regular days off. Must be able to communicate orally, see, and hear to collect information. Must have dexterity to operate office equipment. The incumbent is subject to eyestrain due to the many hours spent looking at a computer screen. Job requires sitting or standing in intervals for long periods of time. The noise level is low to moderate. Answers telephone calls, uses personal computer, and other business machines extensively. Bends, reaches pushes and pulls file drawers to file records and reports. Must be able to transport patients and assist with baggage. Regularly lift or move up to 10 pounds, frequently lift or move up to 25 pounds and occasionally lift or move up to 50 pounds.