Acts as the primary patient liaison upon arrival to the Emergency Department, initiating patient flow and performing all functions necessary to comply with managed care contracts and CMS regulations. Conducts face-to-face interviews with patients and/or family members in a fast-paced, high-acuity environment to achieve successful clinical outcomes and maintain charge integrity in a clinically driven revenue cycle. Processes patient accounts in accordance with departmental and institutional policies and procedures. Responsible for accurate registration of patient demographics and insurance, assures the validity of incoming data, corrects information as needed, and processes the registration including explaining and obtaining patient signatures on the Consent for Admission/Treatment, Release of Information/Assignment of Benefits and Financial Responsibility, and completing Medicare Secondary Payer (MSP) questionnaire. Collects proper consent for Missouri Health Connection to share PHI data. Assesses and interprets Medical Necessity guidelines with providers to prevent denials and to comply with CMS regulations to formally notify the patient of their rights and limitations via the appropriate format. Documents actions taken, answers inquiries involving patient registrations, and research problems to assure payment. Scans documents to the patient's medical record via Cerner Imaging Functions. Verifies insurance eligibility and benefits to notify patients of expected financial responsibility and collects at time of service. Provides financial counseling concerning payment options and financial assistance. Reviews provider orders for accuracy and completeness and follows up with physician offices as needed.
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PHYSICAL DEMANDS: While performing the duties of this job, the employee is regularly required to sit. The employee is occasionally required to stand, walk, reach with hands and arms, stoop, and bend; and may require lifting of paper weighing up to 20 pounds. The position requires manual dexterity to operate computer keyboard, calculator, telephone, and other office equipment as necessary. Position requires continuous viewing and typing on computers and use of the telephone. Vision and hearing must be within normal range.
MENTAL / EMOTIONAL DEMANDS: Mental activities necessary for this position include concentration, organization, multi-tasking, problem solving, stress control, dependability, and both verbal and written communication skills. This position involves frequent contact with staff and patients. Work is frequently stressful and fast-paced. Contact may involve dealing with angry, upset, or emotionally distressed people. Interaction with others is constant and interruptive. Position requires maintaining a high degree of confidentiality.
WORK ENVIRONMENT: Work is performed in an Emergency Department setting. The employee may be exposed to emotionally charged situations and must maintain composure and professionalism at all times.
The most significant of duties are included but this does not exclude occasional work assignments not mentioned or developmental duties.
Associate Degree or equivalent work experience required.
