Insurance Verifier - FT - Days
The Registration Representative performs general registration functions including appointment scheduling, collection of applicable co-pays, co-insurance, and deductibles and utilizing the computer system. Obtains complete and accurate patient demographic, insurance, financial information and patient benefits/eligibility; referral/pre-authorizations/pre-certifications approvals from insurance companies and physician offices.
- High School Diploma/GED is required.
- Excellent customer service skills.
- Computer skills required with knowledge of Microsoft Office suite.
- Good written and verbal communication skills required.
- Bilingual – English/Spanish.
- Must be able to respond to patient needs by interpreting facial expressions and to communicate effectively utilizing verbal and written communications.
- One (1) year of related customer service experience
- Requires reasoning ability and good independent judgment.
- Requires working with frequent interruptions and have strong customer service skills.
- Must have good working knowledge of computers.
- Knowledge of medical terminology and the ability to communicate in both Spanish and English is strongly preferred.
- Promotes the facility mission, vision and values by effectively communicating them to others. Considers mission, vision and values in developing services, standards and practices
- Demonstrates high quality Service Excellence, positive customer service and telephone etiquette by treating all customers with dignity and respect; utilizing age specific skills and knowledge.
- Ensures patient confidentiality requirements are met in accordance with HIPAA policies and procedures.
- Interviews patient or responsible party to obtain demographic information required to register the patient accurately.
- Obtains and reviews doctor’s orders for appropriate signature, date, diagnosis and admission status prior to registration.
- Communicates effectively with doctor’s office to obtain orders when missing or when additional diagnosis is needed for medical necessity.
- Reviews and confirms patient's financial information by obtaining the insurance carrier information, benefit information, policy number, group name and group number.
- Ability to identify the appropriate coordination of benefits for insurance carrier.
- Utilizes on-line verification systems, i.e. TMHP, FISS, and Availity, etc., for eligibility.
- Explains rates, estimates charges for services and hospital policy regarding up-front collections as needed.
- Opens and closes cash batches appropriately and uses the approved naming guidelines.
- Collects deductibles, co-pays, unpaid balances and co-insurance payments and provides patient a receipt.
- Determines financial status and refers patient for financial screening as appropriate.
- Adheres to Administration on-call schedule, if Financial Counselor is off duty.
- Performs appointment scheduling functions and registers patients for ancillary services.
- Initiates Order Management to enter orders as needed.
- Reviews records of any prior patient visits to determine status of any unpaid balances.
- Ability to take over the counter payments from patient statements.
- Ensures referral/pre-authorization/pre-certification requirements have been met.
- Accurately completes the Medicare Secondary Payer (MSP) form as appropriate.
- Initiates Pathway Compliance Advisor to determine if an ABN will need to be provided to patient for services identified as not medically necessary.
- Provides patient the Important Message from Medicare for all Medicare inpatient admissions.
- Ensures patients are provided Conditions of Admission form and signature is obtained.
- Scans photo ID, insurance cards, doctor’s order in the appropriate document type in RegAssist.
- Utilizes Form Fast to print or reprint forms and labels.
- Verifies and places appropriate wrist bracelet on patient with the two required patient identifiers.
- Accurately reconciles cash drawer, creates deposit and adheres to security measures.
- Completes the necessary reports and patient logs, on a daily basis.
- Ability to assemble patient charts in the proper order for next day schedule.
- Effectively communicates information about scheduled case procedures to various departments and personnel.
- Consistently adheres to Doctors Hospital at Renaissance dress policy.
- Other duties as assigned.
LINES OF REPSONSIBILITES:
Director… Assistant Director…Manager … Supervisor…Lead Registration Representative