Job Description
Job Description
Responsible for obtaining patient registration data and assisting clinical staff in completing patient registration and medical necessity tasks. Coordinated patient registration and medical necessity tasks as directed by professional staff. Carries out all responsibilities in accordance with the organization’s core values, applicable policies, procedures and civil laws.
Job Responsibility
- Facilitates and coordinates patient registration and assists clinical staff with obtaining medical necessity information
- Participates in patient registration activities as needed to ensure completion of pre-authorization of services for all patients
- Initiates the referral with documentation in SMS RUMBA/Invision, TRACE, and Canopy
- Utilizes specific electronic system (TRACE, Canopy, ECIN) to transmit all forms and chart documents correctly
- Prepares additional documentation as needed and submits to appropriate insurer
- Ensures that all records , forms, etc., received are complete and processed in a timely manner, contacts physicians as necessary
- Determines in cases where patients have special requirements, i.e., Minor Consents, etc., that all requirements are met and that the hospital is in compliance
- Verifies medical record number prior to admission/registration, and contacts Medical Records Department regarding patients with duplicate numbers
- Coordinates payments due for History and Physical, Cosmetic Package and laboratory tests by noting same in comments field in the SMS system
- Initiates request for online verification of insurance from available insurance companies, views response, determines insurance coverage and selects correct plan code. Maintains an awareness of understanding of patient registration process
- Establishes and maintains relationships with outside resources and serves as a resource for others
- Identifies and meets requirements related to forms and documentation for all payers
- Identifies cases requiring additional supportive demographic or medical necessity information to clinical staff for further work up
- Establishes and maintains relationships with payers to obtain necessary authorizations. Understands and applies concepts related to intricacies of patient registration processes
- Discusses options with payers and providers regarding patient registration and medical necessity based on benefits available to meet those needs
- Prioritizes requests for assistance in order of importance and completes tasks in a timely manner to prevent avoidable delays
- Communicates all necessary information to payer regarding patient registration demographics and medical necessity as needed to obtain necessary authorizations
- Completes registration process within appropriate timeframe and departmental benchmarks. Utilize problem-solving skills effectively
- Demonstrates good interpersonal skills in communicating with all customers and keeps management informed of concerns
- Enhances department growth by support of participation in development and implementation of department goals
- Prioritizes assignments in order of importance and completes in a timely manner
- Identifies creative approaches and takes action steps
- Uses critical thinking and problem-solving skills effectively and seeks direction as indicated
- Sets, discusses, and meets individual goals. Demonstrates positive and professional written, verbal and nonverbal communication skills
- Demonstrates good etiquette and customer service skills in telephone communication
- Substantiates activity by documentation that is entered in a clear, concise, organized, and timely manner per facility and department guidelines
- Demonstrate professionalism and good interpersonal skills in communicating with all customers. Utilizes negotiation skills effectively promoting constructive solutions
- Utilizes appropriated communication style and techniques
- Responds to all inquiries from payers within department guidelines in a professional manner
- Documents CM, quality and risk concerns and refers to appropriate departments as applicable for follow up
- Completes assignments and all reports per departments guidelines
- Scan approval letters into TRACE and files cases with any unresolved or outstanding issues prior to end of duty
- Maintains updated lists of payer and MDO phone and fax numbers in the electronic systems
- Treats all clinical data received in accordance with HIPPA guidelines
- Assist clinical staff with list maintenance for preoperative education classes. Performs related duties, as required.*ADA Essential Functions
Requirements
- High School Diploma or equivalent, required. Some college, preferred.
- Minimum of one (1) years experience in patient registration/patient access.
- Knowledge of hospital terminology.
- Knowledge of Medicare, Medicaid, Managed Care and other health insurance
*Additional Salary Detail
The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining a team member’s base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity).
The salary range for this position is $19.90-$21.11/hour