Job Description

Will be responsible for reviewing patient registration for all types of admissions and elective procedures to ensure patient and guarantor demographic and insurance information is complete and current with each patient visit. The Admissions Registration Specialist I will assist patients with understanding their insurance options and collecting patient financial responsibilities. The Admissions Registration Specialist I will perform all functions in a courteous and respectful manner, advocating for the patient's best interest and wellbeing. Exemplifies the organization's mission, vision and values and acts in accordance with organizational policies and procedures.

Responsibilities

With a high degree of accuracy collects, verifies and enters into Epic the patient's demographic, employer, financial, emergency contact, insurance, subscriber and case-specific information, such as referring physician and diagnosis.

Consistently has patient sign and scan all necessary documents for completion of the admission process; consent, ID, insurance card, MIMS, OBS, COB, etc.

Consistently and accurately obtains and interpret the patient's insurance benefits and possess the ability to communicate this information accurately to the patient and co-workers.

Has the ability to determine the patient's financial obligation and communicate this information accurately and with respect to the patient.

Performs registration functions consistent with Federal, State and Local regulatory agencies and payer requirements, and organizational policies and procedures, including HIPAA privacy and security Regulations, as well as JACHO.

Upon decision of patient's admission, has the knowledge and skill to perform the admission notification (NOA) process which is a required communication with the patient's payer to ensure that the payment for patient's inpatient stay is secured.

Appropriately informs the patients of hospital policies that govern the revenue cycle. Minimizes the potential financial risk of patients accounts by discussing with the patient and/or guarantor their financial responsibility for upcoming visits/procedures, past due balances and referral requirements. Offers options and negotiates acceptable resolution of estimated patient balance.

Receives and properly responds to, or directs telephone inquiries from patients, payers, physicians and their staff, internal department and other persons and entities.

Ability to exercise good customer service skills when communicating with both our patients as well as our internal customers. Able to find resolution within the phone interaction satisfactory to the caller and/or having the knowledge when to escalate to their supervisor.

Interacts and collaborates with numerous departments to resolve issues while also analyzing necessary information that will ensure reimbursement.

Maintains a working knowledge of applicable Federal, State, and local laws and regulations, the organization's Organizational Integrity Program, Standards of Conduct, as well as other policies and procedures to ensure adherence in a manner that reflects honest, ethical, and professional behavior. Guards to assure that HIPAA confidential medical information is protected.

Attends regular EPIC training sessions or other sessions conducted for the benefit of associates involved in the Admitting functions.

• Other duties as needed and assigned by the supervisor/manager.

Required Job Qualifications:

• High school graduate or equivalent.
• 0-1 year of experience. Must have a basic understanding of the core Microsoft suite offerings (Word, PowerPoint, Excel).
• Excellent communication and outstanding customer service and listening skills.
• Basic keyboarding skills. Critical thinking, sound judgment and strong problem-solving skills essential.
• Team oriented, open minded, flexible, and willing to learn.
• Strong attention to detail and accuracy required. Ability to prioritize and function effectively, efficiently, and accurately in a multi-tasking complex, fast paced and challenging department.
• Ability to follow oral and written instructions and established procedures.
• Ability to function independently and manage own time and work tasks.
• Ability to maintain accuracy and consistency.
• Ability to maintain confidentiality.

Preferred Job Qualifications:

• Associate's Degree in Accounting or Business Administration.
• Experience within a hospital or clinic environment, a health insurance company, managed care organization or other health care financial service setting, performing medical claims processing, financial counseling, financial clearance, accounting, or customer service.
• Knowledge of insurance and governmental programs, regulations, and billing processes e.g., Medicare, Medicaid, Social Security Disability, Champus, Supplemental Security Income Disability, etc., managed care contracts and coordination of benefits is highly desired.
• Working knowledge of medical terminology and anatomy and physiology is preferable.