Job Description

Overview

Patient Registration Specialist, Pain Management

Full Time, 80 Hours Per Pay Period, Day Shift

Cumberland Medical Center Overview:

Cumberland Medical Center in Crossville, Tennessee is part of Covenant Health, East Tennessee’s largest nonprofit health system and a Becker’s “Top 150 Places to Work in Healthcare.” Fully accredited by the Joint Commission, Cumberland Medical Center is an acute care hospital offering all private patient rooms as well as comprehensive care including cardiology, orthopedics, maternity, cancer treatment, and wound care. The hospital features emergency and critical care, surgical suites, and specialized programs such as imaging, cardiac rehab, sleep disorder care, and hyperbaric medicine, all in a family-oriented environment focused on exceptional patient care.

Position Summary:

Coordinates the centralized scheduling of all outpatient diagnostic and surgical procedures. Accurate collection and data entry of the required financial and demographic information for all patients registered to our facility. Ensures verification of benefits and pre-certification requirements are met prior to scheduled appointment/admission. Follows up as necessary on all urgent or unscheduled registrations for consistency in the process. Establishes controls so unscheduled patients understand and receive accurate information on their patient liability.

Responsibilities

• Collects co-payments/deposits based on verification information obtained, generates receipts to the payer, and delivers all cash transactions to the cashier for proper posting to the patient account.
• Maintains strict confidentially of patient information.
• Recommends to the Coordinator updates to existing policies and procedures that support our values and are intended to increase efficiency and promote data integrity.
• Notifies the Financial Counselor immediately upon scheduling or registering any potential self pay, worker’s compensation patient, or any non-covered procedures.
• Makes patient type changes based on information given from Medical Records Staff and/or Care Coordinators, ensuring documentation is present in the medical record to support the change.
• Ensures all reservations are properly documented to support departmental statistics. Enters faxed reservations into the HBOC scheduling system.
• Schedules operative and diagnostic procedures utilizing the HBOC scheduling system. Documents each scheduled procedure/event with detailed information. Notifies departments of any special resources required for procedure/event.
• Verifies insurance benefits and obtains pre-certification from various third-party payers. Has extensive knowledge of insurance plan requirements. Provides necessary documentation to DHS and Med Assist staff for patients potentially in need of financial assistance or TennCare enrollment.
• Efficiently gathers all demographic, medical and financial information for scheduling, registration, and verification of patient accounts utilizing the HBOC computer system to record data. Enters verification and pre-certification notes into SMS financial system as cross-reference.
• Participates with clinical and care management areas to address opportunities to improve overall collections and cash flow.
• Analyzes claims denial data for opportunities to achieve improved collections, enhance relations with insurance companies and physician practices, and improve workflow process.
• Reports pertinent procedural changes/updates to appropriate leadership.
• Professionally deals with patients, physicians, visitors, and other hospital staff members.
• Demonstrates ability to keep abreast of regulatory and insurance requirements ensuring that changes are incorporated in daily job functions.
• Assures the registration process is handled in a professional manner, maintaining registration accuracy rate of 95 to 100 percent.
• Explains a variety of necessary information to the patient/family member, such as: consent for treatment, advance directives, medical/financial release, deposit requirements, billing and payment polices and advanced beneficiary notices.
• Recognizes situations that necessitate supervision, seeking appropriate resources.
• Directs, escorts, and/or provides wheelchair assistance to the patient upon completion of the registration process to the appropriate nursing unit or diagnostic testing area.
• Demonstrates motivation necessary for acceptable productivity.
• Understands goals and objectives for the department that take into consideration the mission and values of Covenant Health.
• Performs pre-registration process by utilization of phone and mail techniques, advising the patient during the conversation of any co-pay or deductible amounts due upon admission.
• Maintains an accurate bed board, utilizing the computerized bed tracking system so wait times for admitted patients are kept to a minimum.
• Coordinates with Nursing Services the flow of inpatient and observation patient admissions.
• Displays competence in use of all Information Computer Systems that supply information regarding patient registration and scheduling (DeRoyal, HBOC, Account Link and Medifax).
• Updates schedules daily of unexpected procedures, cancellations, or changes and communicates with all individuals affected by revisions.
• Shows initiative to cross-train in all duties related to; scheduling, registration, verification, and pre-certification.
• Prepares the patient account folder by scanning all vital registration/scheduling/verification documents into the optical imaging system. Examples of documents: insurance cards, financial agreements, ER charge sheets, verification sheets, pre-certification letters, and physician orders. Will also index the document(s) using the optical scanning system, placing the document(s) in the correct electronic file folder.
• Demonstrates the ability to handle varying tasks and setting priorities.
• Utilizes resources available appropriately, i.e., use of hospital equipment and/or supplies.
• Activates manual systems for computer network downtime, printing schedules in advance when necessary. Notifies leadership of unscheduled downtime occurrences.
• Coordinates scheduling of classrooms for meetings, conferences, etc., ensuring confirmation is provided for the correct date and time.
• Follows policies, procedures, and safety standards. Completes required education assignments annually. Works toward achieving goals and objectives, and participates in quality improvement initiatives as requested.
• Performs other duties as assigned.

Qualifications

Minimum Education:

None specified; will accept any combination of formal education and/or prior work experience sufficient to demonstrate possession of the knowledge, skill, and ability needed to perform the essential tasks of the job, typically such as would be equivalent to a high school diploma or GED. Preference may be given to individuals possessing a Bachelor’s degree in a directly-related field from an accredited college or university.

Minimum Experience:

One (1) year experience in a hospital or financial setting OR minimum three (3) years of total customer facing/customer service experience required.

Licensure Requirement:

None