JOB PURPOSE OR MISSION: Provide Outpatient admissions services to all patients at a level consistent with Baton Rouge Rehabilitation Hospital (BRRH) mission, vision, and values.
JOB FUNCTIONS
ESSENTIAL JOB FUNCTIONS include, but are not limited to:
1. Facilitates patient safety.
PERFORMANCE STANDARDS:
- Accurately identifies patients based on current policy.
- Actively participates in and demonstrates effective patient and employee safety practices.
- Maintains knowledge of and adherence to all applicable safety practices appropriate to job position including but not limited to: Incident reporting, handling of wastes, sharps and linen, PPE, exposure control plans, hand washing, environment of care, patient identification, administers/receives patient orders, validates, transports, monitors or observes patients for procedures, and monitors clinical alarms.
- Reports on any safety concerns and broken or malfunctioning equipment to supervisor, facilities maintenance or biomed in a timely manner.
2. Pre-registers and registers patients.
PERFORMANCE STANDARDS:
- Completes tasks in timely, accurate and consistent manner to minimize patient delays.
- Conducts confidential and professional interview with patients or patient’s representative to complete pre-registration and registration.
- Coordinates insurance coverage with patients, insurance company and Business Office.
- Communicates special patient needs to appropriate staff.
- Accurately verifies insurance and obtains precertification/authorization prior to patient admission.
- Communicates with insurance representatives for authorizations to promote continuity in covered care.
- Interpret insurance verification data and takes appropriate action related to insurance responses.
- Maintains an overall error rate at or below 5%.
- Completes activation function of all registered patients facilitating timely patient account functions.
3. Computes, requests, collects, and receipts monies.
PERFORMANCE STANDARDS:
- Reviews co- payments and payments with the patient or patient representative then documents per policy.
- Collects co-payments and payments due and documents according to policy.
- Reports any variation from normal process.
- Enters charges and codes into billing software and data logs accurately.
- Reviews and addresses accounts on unbilled and denial logs in a timely manner.
- Problem solves and corrects issues on unbilled and denial log.
4. Completes documentation
PERFORMANCE STANDARDS:
- Documents all aspects of admissions information in thorough, accurate and timely manner according to departmental, Medicare and Joint commission documentation standards.
- Creates initial medical record packet for patient.
- Distributes all records to appropriate departments in timely and consistent manner.
- Completes admissions paperwork upon arrival of the patient.
- Scans patient information including driver’s license and insurance card into the computer system.
- Completes discharge process in timely manner.
- Faxes patient evaluations, progress notes, prescriptions, etc., and follows-up on all correspondence within defined timelines.
5. Promotes Team Approach
PERFORMANCE STANDARDS:
- Answers the telephone by third ring. Transfers calls accurately.
- Greets patients and guests by directly acknowledging them.
- Assists guest or caller by answering questions, providing information, or solving problems before transferring to therapy staff.
- Takes accurate messages.
- Informs the therapist that the patient has arrived.
- Relays information to outpatient staff regarding schedule or changes
- Accurately schedules patients for therapy using scheduling software focusing on maximizing full and part-time staff productivity and minimizing need for PRN or assistance from other departments.
- Is present, prepared, and participatory for mandatory meetings.
- Works with outside vendors to order patient equipment.
- Provides staff training to promote accurately following insurance guidelines etc.
- Communicates information for authorizations in timely manner to decrease disruption in care.
- Participates in department management tasks; supervises, trains, mentors and orients new staff, students and volunteers.
- Completes assigned projects by due date
6. Maintains compliance.
PERFORMANCE STANDARDS:
- Follows the Code of Conduct, Conflict of Interest, Medicare, Joint Commission Guidelines and policies and procedures.
- HIPAA: Maintains knowledge of and adherence to all applicable HIPAA regulations appropriate to Job Position including but not limited to: Medical records w/o limitation both paper and electronic, patient demographics, lab and radiology results, patient information related to surgery or appointment schedules, information related to patient location, religious beliefs and/or public health records, medical records related to quality/data, patient financial information and/or 3rd party billing, patient-related complaints, and research information.
- Follows all Medical Treatment and Labor Act (EMTALA) regulations.
- Maintains compliance in completing all documents required by specific payers for each patient registration.
- Upholds ethical principles via accurate billing and processing.
7. Participates in performance improvement.
PERFORMANCE STANDARDS:
- Reports any variations from normal process.
- Actively participates in Performance Improvement activities and incorporates quality improvement standards in his/her job performance.
- Offers suggestions for process improvement; recommends to the supervisor/manager equipment and/or supplies that may enhance our program.
8. Other tasks
- Works on holidays during emergency situations as required to meet patient needs and maintain compliance with outpatient guidelines.
- Utilizes KRONOS or App to clock in and out consistently, request time-off and independently monitors timecard, benefits, and notifications.
- Manages daily schedule considering patient needs, co-worker’s schedules, and productivity.
- Assists other departments as needed due to census, skill set, schedule etc.
- Volunteers for or participates when assigned in hospital teams, committees, projects and marketing.
9. Performs other duties and special projects as required.
High School Diploma or GED required; higher education preferred.
Customer Services Experience Required
intermediate computer skills with experience in Windows, Excel, Word and Outlook.
Oral and written communication skills required.
Ability to work in an interdisciplinary environment.
Good organizational skills.
Prior experience in Insurance or Patient Registration in healthcare environment preferred
Previous experience verifying insurance benefits is preferred.
Physical criteria:
- Lifting Medium: Ability to lift up to 50 pounds occasionally (33%), 10-25 pounds frequently (34-66%) and 0-10 pounds constantly (67-100%) with frequent lifting/and of carrying objects weighing up to 25 pounds.
