The Lemuel Shattuck Hospital (LSH) is seeking an experienced and committed Patient Registration Representative.
The Benefits Eligibility & Referral Social Worker, Patient Registration Representative, is responsible for registering inpatients and outpatients, verifying insurance eligibility, providing financial assessment and counseling, making financial eligibility determination, obtaining insurance authorizations and data entering client information into the computerized billing system.
Duties and Responsibilities (these duties are a general summary and not all inclusive):
Provides financial counseling for all new and returning self-pay outpatients utilizing the hospital sliding fee scale.
Ability to function efficiently in the Meditech system, in daily operations of department.
Utilize department procedures in identifying patients upon admission or registration.
Registers new and returning outpatients; establishes medical record; prints face sheet and labels for new patients; and updates information for returning patients and upon each registration print labels.
Verifies financial eligibility for Medicaid and obtains information of third party liability, managed care group and primary care physician through Medicaid Management Information System (MMIS) and POS device.
Determines client eligibility for financial assistance by reviewing applications and related documentation, interviewing patients, and applying standard eligibility criteria to determine eligibility for financial assistance and related benefits.
Assists eligible clients in obtaining assistance by helping clients complete applications for benefits such as bill reduction, Masshealth and disability benefits; performs arithmetic computations to determine eligibility for programs, and assist patients in obtaining required documentation.
Educates patients on financial eligibility to ensure they are aware of their options and can make informed decisions.
Monitors cases completed by contacting clients, Division of Medical Assistance (DMA), and UMass Disability Determination Unit to ensure continuing eligibility for benefits.
Prepares and maintains records on assigned cases including writing reports.
Compiles statistics of outpatient activity including self-pay visits.
Pre-register weekly GI procedures, print labels and wrist bands.
Completes and submits all Admission and Discharge SC1’s to appropriate Mass Health offices.
Ensures that all patients have prior authorization for services when required including any managed care organizations (such as CMA, CMA, CHS, NHP), Medicaid PCC’s and HMO’s, Houses of Correction and commercial insurances and calls for authorizations as needed.
Updates and edits patient files, with new and/or additional information.
Inquires of all patients at each date patient visit whether their address or insurance information has changed and updates patient files accordingly.
Corrects all data entry and patient information errors promptly according to hospital procedure as directed by supervisor.
Explains forms to patients and obtains signatures from patients on consent for treatment and Notice of Privacy Practices.
Schedules appointments for patients in 28 Ambulatory Care Center Clinics either directly with the patient or via phone utilizing computerized scheduling system
Admits patients to the hospital. Conducts patient interviews to obtain patient information (address, insurance coverage, etc.), establishes medical record for new patients and retrieves medical record for re-admissions, prints face sheet , data enters information into computerized billing system , issues wrist identification band, verifies patient's insurance, and submits necessary insurance forms. billing system.
Functions as a team member and assists other members of the team in ensuring that daily data entry and other work-related duties are completed within specified time frames.
Maintains cross training with other positions in the Department in order to ensure the efficient and prompt registration of clients and to ensure that position is covered at all times.
Functions as back-up person in the absence of a team member.
Communicates with patients and staff in a harmonious, professional and courteous manner.
Maintains professionalism and ensures that customer service is the number one priority and that patient rights and confidentiality are respected at all times.
Participates in regularly scheduled team meetings.
Participates in the hospital-wide Continuous Improvement Initiative Program.
Complies with and maintains knowledge of Hospital Environmental and Safety Regulations.
Performs other related duties as assigned by supervisor.
8:00 a.m. to 4:00 p.m.
Saturday and Sunday
LSH takes pride in helping people recover from illnesses and conditions that are often underserved or difficult to manage in other health care settings. The Hospital serves populations that are mostly indigent, often in the care and custody of state agencies, and present with clinical issues that arise from mental illness, homelessness, and substance abuse. LSH provides 260 inpatient beds and 25 specialty medical clinics, including surgical services, to patients and clients referred by private sector providers and state agencies (including the Department of Public Health (DPH), the Department of Mental Health (DMH), the Department of Developmental Disabilities (DDS), and the Department of Corrections (DOC)). We strive continuously to improve the quality of life for our patients through the delivery of collaborative treatment and a patient-focused continuum of care. Teaching professionals from various health disciplines always have been a part of the hospital’s charge as well.
A criminal background check will be completed on the recommended candidate as required by the regulations set forth by the Executive Office of Health and Human Services prior to the candidate being hired. For more information, please visit http://www.mass.gov/hhs/cori
Education, licensure and certifications will be verified in accordance with the Human Resources Division's Hiring Guidelines
Education and license/certification information provided by the selected candidate is subject to the Massachusetts Public Records Law and may be published on the Commonwealth's website.
For questions, please contact Health Human Resources at 617-971-3087.
First consideration will be given to those applicants that apply within the first 14 days.
MINIMUM ENTRANCE REQUIREMENTS:
At least two years of full-time, or equivalent part-time, professional or paraprofessional experience in social work or social casework, claims adjudication, job placement, recruitment, employment counseling, vocational or rehabilitation counseling, credit investigation, educational counseling, legal advocacy, or legal counseling.
- A Bachelor's or higher degree may be substituted for the required experience on the basis of two years of education for one year of experience.
- One year of education equals 30 semester hours. Education toward a degree will be prorated on the basis of the proportion of the requirements actually completed.
Based on assignment, travel may be required. Those employees who elect to use a motor vehicle for travel must have a current and valid Massachusetts Class D Motor Vehicle Operator's license or the equivalent from another state.
An Equal Opportunity/Affirmative Action Employer. Females, minorities, veterans, and persons with disabilities are strongly encouraged to apply.