Job Objective:
Under the direction of the Department Supervisor or other designee provides a variety of patient welcoming and access services in support of the Admitting/Registration areas. Pre-registers and registers patients presenting at the hospital for inpatient, outpatient and emergency services. Conducts patient/guarantor interviews, explains hospital policies, patient financial responsibilities and patient's bill of rights. Facilitates the patient registration/admission flow, including activities such as: patient identification, identification of accurate demographic and insurance information, and collection of required signatures and documents. Responsible for the verification of insurance benefits on all inpatient and outpatient accounts through electronic verification system or through contact with third party payors, in order to obtain accurate and prompt reimbursement. Checks eligibility, benefits, authorization requirements, PCP approval requirements, and billing requirements, as appropriate. Submits notice of admission to payors, as needed. Collects co-payments, and other patient liabilities. Enters the financial and admissions data into the hospital information computer systems.
Duties and Responsibilities:
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Registration/Pre-registration
- Obtain, verify and correct demographic information, select correct guarantor and emergency contacts on all registrations/pre-admissions
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Chooses the correct patient type as indicated by MD order or pre-admit order and the current registration systems
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Ensures that all required insurance authorizations are obtained at the time of registration/pre-registration
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Ensures that all insurance verifications are obtained at the time of registration/pre-registration
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Collects all co-pays and deductibles at the time of registration/pre-registration
- Uses proper patient identifiers when selecting the patient record into the hospitals ADT systems as outlined in the facilities policies and procedures
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Completes Medicare Secondary Payer form correctly
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Completes registrations/pre-admissions without creating a duplicate medical record number
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Completes registrations\pre-registrations with correct Primary Care MD, Admitting MD and Attending MD.
- Forms Completion
- Explains all admission forms accurately and understandably and direct patient and or responsible party to initial and sign were applicable on all forms
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Explains the Medicare Rights form to patients that this form applies
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Understands the purpose of the Patient Responsibility form in regards to Core Measures and the timely completion of the form and Smoking Cessation information.
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Uses military time on all admission forms
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Uses a legal signature on all admission forms
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Understands chart placement of all forms
- Advance Directives and Patient Information
- Explains Advance Directives and direct patients to their MD for completion of form
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Provides all required information such as Patient Rights and Responsibilities, Speak up Brochure and use of blood at the time of registration
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Provides patients and their families with assorted required documents to assist them during their stay
- Organization of daily activities
- Monitors and coordinate work daily to achieve maximum productivity and efficiency
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Review all work for quality at the end of each shift and make corrections if necessary
Non-Essential Duties:
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Other duties as assigned, within skill sets and abilities
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Ensures insurance authorizations are received and documented in the patients account as required by insurance carriers
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Obtains insurance verification on all required patient accounts as outlined in the department’s policies and procedures
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Accepts and carries out all other miscellaneous clerical and/or administrative duties and responsibilities as required for maintaining all services provided by Admitting Services
Knowledge, Skills and Abilities:
Knowledge
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Knowledge of medical terminology
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Knowledge of HMO, PPO, Commercial, and Workers’ Compensation reimbursement
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Knowledge of multiple insurance plans and authorization procedures and processes for obtaining payment
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Knowledge of Microsoft Office applications
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Knowledge of basic arithmetic
Skills
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Use of basic personal computer
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Use of the use of a calculator
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Proficient in the operation of scanners, copiers, and fax machines
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Skilled in usages of computers and programs in a hospital setting
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Skilled usage of MS Office applications
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Strong communication and organizational skills
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Good planning, time management and decision-making skills.
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Good analytical and problem-solving skills
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Excellent interpersonal skills and strong customer focus
Abilities
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Ability to read and understand insurance requirements
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Ability to verify and interpret insurance benefits and collect co-pays
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Ability to handle stress
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Ability to manage a heavy caseload in an organized and efficient manner
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Ability to maintain a working relationship with other departments within the organization
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Ability to read handwritten and transcribed documents in the medical record, interpret information,
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Ability to enter complete and accurate data into the facilities computer systems
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Ability to maintain an accuracy rate of 98% or higher relating to all registration/preadmission/bed control activities within the Patient Access departments
Education and Experience:
Education
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High School graduate or equivalent
Experience
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1-year recent experience in an Admitting Department in an acute care setting preferred. Will consider 1-year experience in a medical office or hospital Business Office setting
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Previous Commercial, HMO, PPO, and Workers Compensation billing and/or insurance follow-up experience in an acute care setting preferred
Required Licensure and/or Certifications:
Physical Requirements and Working Conditions:
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Primarily works in a climate-controlled area
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Frequent Sitting and standing for long periods of time
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Tolerate repetitive arm and hand movements
A detailed description of the physical requirements of this job is maintained in the Employee Health Department.
Education and Experience:
Education
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High School graduate or equivalent
Experience
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1-year recent experience in an Admitting Department in an acute care setting preferred. Will consider 1-year experience in a medical office or hospital Business Office setting
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Previous Commercial, HMO, PPO, and Workers Compensation billing and/or insurance follow-up experience in an acute care setting preferred
Required Licensure and/or Certifications:
Physical Requirements and Working Conditions:
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Primarily works in a climate-controlled area
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Frequent Sitting and standing for long periods of time
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Tolerate repetitive arm and hand movements
