Reports to the Department's Designee. Follows established policies and procedures to admit and register patients for services in a professional and courteous manner. Is responsible for accurate and complete registration of all patients. Must maintain regulatory and functional knowledge of all information required which ensures timely and accurate reporting/billing. Collects applicable co-payments and deductibles and completes insurance verification and must be able to accurately decipher eligibility responses and relay that information back to the patient. Obtains all required signatures on paperwork and performs clerical duties as necessary.MISSION, VALUES and SERVICE GOALS
MISSION: We deliver outstanding care, inspire health, and connect with heart.
VALUES: Trust. Respect. Integrity. Compassion.
SERVICE GOALS: Personally connect. Keep everyone informed. Be on their team.
Registers patients (in order to obtain demographic, physician and insurance information in accordance with established departmental policies and procedures) and collects applicable co-payments and deductibles by:
Interviewing patients for pre-admission or upon presentation for admission in the registration or designated area.
Promptly works alerts through the Teletracking system by creating an account for all direct admits, transfers, and add-on procedures.
Obtaining identification, demographic, physician and insurance information from patients and accurately entering this information into the financial system.
Audits each account for demographic errors by using Financial Clearance Workstation (FCW).
Updating the system after validation of the new patients financial information.
Using the Pathways Healthcare Scheduling (PHS) or Cerner databases to locate/retrieve scheduled patients for admission/registration input into STAR.
Generating PHS and SurgiNet reports to facilitate pre-registration.
Explaining about the possible need to pre-certify with the patients insurance carrier in order to ensure maximum coverage to the limits of the insured's insurance policy.
Verifying and documenting insurance coverage via online eligibility systems, internet resources or via telephone.
Requesting copies of the insurance card(s) and driver's license or other government picture ID to confirm insurance benefits and identification.
Providing the Medicare letter for Medicare patients; also completing the Medicare Secondary Payor Questionnaire (MSP) and Advance Beneficiary Notice (ABN).
Validating medical necessity via the MCA Compliance Checker where applicable.
Completing the MSP (Medicare Secondary Payor) questionnaire by asking the patient the questions based on patient availability.
Requesting payment either during the pre-registration process or when the patient presents for service in accordance with policies and procedures.
After collecting applicable co-payments and deductibles, posting patient payments (including cash, checks and credit cards) on the patient's account and generating a system receipt to give to the patient.
Maintaining a cash drawer in order to make the appropriate change for patients making payment at the time of service; also responsible for balancing and reconciling the cash drawer at the end of the shift.
Referring the patient to the Financial Counselors or Eligibility Specialists if they are unable to secure satisfactory payment arrangements and have a self-pay balance of $500 or more. Also assisting in obtaining additional patient information, copies of insurance card(s) and church information.
Obtaining all required signatures for the "consent to treat" and assignment of insurance benefits forms.
Coordinates the insurance eligibility and pre-certification/documentation (PA) processes for patients by:
Verifying insurance coverage and network status by using online eligibility systems and websites to determine the patient's benefits under the insurance plan.
Audit insurance eligibility by using the Relay Connect dashboard to verify insurance is eligible and correct.
Verify network eligibility for potential transfers for Transfer Direct.
Obtaining VOB information from the insurance company, such as: co-payment, co-insurance, deductible, the amount of the deductible that has been met year-to-date, family deductible, maximum out-of-pocket limit
Education and Experience
The knowledge, skills and abilities as indicated below are normally acquired through the successful completion of a high school diploma (or equivalent). A minimum of one year of previous hospital or medical office experience is required. A medical terminology course must be successfully completed during the first year of employment. Additional college-level courses in the medical practices area are desired. Associate's degree preferred. CHAA certification is highly preferred.
Knowledge & Skills
Requires basic office and keyboarding skills (with the ability to type a minimum of 40 wpm) and the ability to use designated reference materials and office equipment (i.e., computer, printer, fax machine, calculator, etc.).
Requires effective telephone skills (for example, to accurately take and relay information about patients, physician orders and referrals).
Demonstrates proficient computer skills (i.e., data entry, word processing and spreadsheets). Requires the ability to use multiple databases (such as Pathways Healthcare Scheduling, RelayHealth, Cerner and MCA Compliance Checker).
Requires a complete understanding of time of service collections. Specifically, must understand why it is necessary and must be able to effectively communicate this to Beacon Health System's patient community as necessary.
Requires basic knowledge of medical terminology, private insurance coverage (and managed care).
Demonstrates the interpersonal skills necessary to interact effectively with patients from various backgrounds in a professional, enthusiastic, courteous, friendly, caring and sincere manner. Also demonstrates the ability to maintain effective working relationships with other departments, physicians and their office staff.
Demonstrates the verbal communication skills needed to communicate in a clear and effective manner when conducting patient interviews, answering patient's ques
