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About the Role

Front-line Revenue Cycle Team member responsible for efficient processing of scheduled cases, reservations, and registrations for various patient types. Performs clerical duties to facilitate patient throughput and access to medical care, while securing financial information for revenue generation. This includes obtaining and recording patient demographics, contact, and insurance information, as well as handling notifications and precertification.

Responsibilities

Obtain and record patient demographics, contacts, and insurance information.
Handle notifications and precertification.
Type a minimum of 40 words per minute.
Utilize computers for data entry.
Multitask effectively amidst reasonable distractions.
Prioritize and reprioritize tasks as needed.
Work collaboratively in a team and independently.
Verify insurance for various payer types (HMO, MCR, MCD, BC, WC, NF, liability, traditional indemnity).
Demonstrate professionalism, sensitivity to cultural and linguistic diversity, and customer service skills.
Take initiative and be proactive in servicing customers.
Collaborate courteously and respectfully with all staff, patients, physicians, and clinical staff.
Process and complete admissions/registrations for elective, ambulatory surgery, urgent, and emergency patients.
Electronically verify insurance for accounts registered as Self-Pay.
Comply with Sliding Fee and Financial Aid Policies.
Inform patients about hospital policies regarding financial obligations, co-payments, deposits, personal items, and visitation rights.
Offer Medicaid Document Lists to self-pay patients and refer them to the Medicaid Office.
Document patient accounts to communicate team efforts.
Interview patients/representatives in person or by phone to obtain demographic and financial/insurance information.
Maintain patient confidentiality at all times.
Obtain verification, insurance notification, precertification, and authorizations for various insurance types.
Verify benefit eligibility and authorization requirements via multiple channels (Tel, fax, Web, Electronic Verification tools).
Input subscriber, polls, group name, and plan types according to policy.
Contact employers for WC or NF information on relevant cases.
Answer telephone calls, respond to inquiries, and route calls or take messages.
Accept reservations for Direct Inpatient Admissions and Ambulatory Surgery procedures.
Translate verbal or written diagnosis and procedures into appropriate ICD-9 or CPT codes for authorization.
Schedule, pre-admit, or admit patients according to policy.
Enter necessary comments and collection notes.
Record advanced directive status of patients and collect, chart, and file Advanced Directives.
Collect patient Discharge Notice Slips and promptly enter discharges into the computer system.
Ensure accurate reflection of vacant beds in the computer system and patient bed board.
Assign beds according to established bed priority and utilize bed tracking and census tools.
Coordinate and document intra-hospital patient room transfers.
Assign patients to hospital rooms and beds based on various factors and guidelines.
Obtain patient signatures authorizing treatment, assignment of benefits, and release of information.
Prepare initial Medical Record Chart, identification bands, and labels.
Assist families, Funeral Homes, and Coroner's Office with inquiries and documentation for death certificates.
Process Birth Worksheets, Birth Certificates, and obtain necessary signatures.
Process requests for Newborn MCD and Social Security numbers.
Process Spontaneous Termination of Pregnancy and request medical records if needed.
Conduct daily L&D and Maternity Unit walk-throughs to interview patients.
Support team efforts to secure financial information.
Review and update face sheets and patient information to ensure notifications, verifications, and authorizations are secured.
Use all available tools to verify benefits.
Report changes in patient information to Utilization Management, Medicaid Office, and other relevant associates.
Prepare Testing Requisitions and affix labels as necessary.
Attach all necessary forms to Pre-Admission packages.
Place calls to BMP Director as necessary.
Perform all other duties as required.

Requirements

Must type a minimum of 40 words per minute.
Multitasking is necessary.
Ability to prioritize and reprioritize as additional tasks develop or are assigned.
Able to work well with a team and independently.
Previous front-line medical office, billing, or hospital registration experience or skills are a must.
Knowledge of insurance verification process for HMO, MCR, MCD, BC, WC, NF, liability, and traditional indemnity third party billing and payers is a must.
Mature, accountable, and punctual; reports to work promptly as scheduled.
Incorporates professionalism, sensitivity to cultural and linguistic diversity, and customer service skills.
Takes initiative and is proactive when servicing customers.
Collaborates with and is courteous and respectful to all WHMC staff, patients, physicians, nurses, other clinical staff, and WHMC associates.
Flexible and able to process and complete Elective, Ambulatory Surg, Urgent Emergency patient admissions/registrations.
Electronically checks any and all electronic and web verification resources to enable the PASR to identify if any accounts registered as Self-Pay have insurance.
Complies with WHMC Sliding Fee and Financial Aid Policies.
Ensures that patients are made aware of hospital policies and procedures, including those regarding financial obligations, co-payments and deposits, personal items and visitation rights.
Offers patients that remain "true" Self-Pay a Medicaid Document List and refers those patients to the on-site Medicaid Office if Inpatient and Off-site Medicaid if Outpatient.
Documents patient accounts accordingly to communicate efforts of the PASR Team.
Interviews patients/patients' representatives in person, at bedside, or by phone to obtain necessary demographic and financial/insurance information for each admission/registration.
Maintains patient confidentiality at all times.
Obtains Verification, provides necessary insurance notification, obtains precertification and authorizations for Commercial, MCD, MCR, BC, HMO, Campus, MCDPCPs, MCRHMOs, No-fault, and Worker's Compensation.
Verifies benefit eligibility & Auth requirements, via Tel, fax, Web & Electronic Verification tools.
Inputs Subscriber, Poll's, Group Name & Plan Types in accordance with policy.
Contacts employers to obtain WC or NF Info on WC and NF cases.
Courteously answers telephone calls and responds to inquiries and/or requests in accordance with established policy and procedures.
Routes calls or takes messages as appropriate.
Accepts reservations for Direct Inpatient Admissions and Ambulatory Surgery procedures as requested by the Attending Physicians or their respective designees and ensures the completion of reservation forms.
Translates verbal or written diagnosis and procedures into appropriate ICD-9 or CPT code in order to obtain authorization.
Appropriately, Schedules, Pre-Admits, or Admits patients as per established policy.
Enters necessary comments and collection notes.
Records advanced directive status of patients and collects, charts and files Advanced Directives.
Collaborates with appropriate Hospital Associates regarding Special "Advanced Directive Circumstances".
Collects patient Discharge Notice Slips.
Promptly enters discharges in computer system and ensures that vacant beds are accurately reflected in the computer system and patient bed board at all times.
Assigns beds in accordance with established bed priority, uses bed tracking and census tools to expedite processing of decisions to admit.
Coordinates and documents intra-hospital patient room transfers in collaboration with the Nursing Staff and in accordance with priorities established in departmental policy and procedure.
Assigns patients to a hospital room and bed, based on sex, diagnosis, age, current patient census and in accordance with guidelines and priorities established in departmental policy and procedures.
Obtains patient signatures authorizing treatment, assignment of benefits release of information and acknowledging receipt of patient packages.
Prepares initial Medical Record Chart for encounter, identification bands and labels.
Where appropriate, assists families, Funeral Homes and Coroner's Office regarding inquiries and documentation in the preparation of death Certificates.
Where Appropriate, Birth Registrars' Only: Accurately & Timely processes Birth Worksheets, Birth Certificates and obtains signatures from MDs.
Processes requests for Newborn MCD and Social Security numbers.
Where Appropriate, Birth Reg Only: Accurately and Timely Processes Spontaneous Termination of Pregnancy, may request Medical Records.
Where Appropriate, Birth Reg Only: Conducts daily L&D and Maternity Unit walk throughs to interview patients.
Where appropriate, Financial Follow-up PASRs: Review and accurately update or revise face sheets and patient information to ensure notifications, verifications and authorizations are secured.
Where appropriate, Financial Follow-up PASRs: Timely Report changes to Patient information to Utilization Management, Medicaid Office and other Hospital Associates as necessary.
Where appropriate, PST PASRs: Promptly Prepare Testing Requisitions affixing Labels as necessary.
Attach all necessary forms to Pre-Admission package i.e. Adv. Directives, Multiparity, Hysterectomy, NF, WC.
Place calls to BMP Director as necessary.
May see blood, other body fluids.
May see patients who are intubated, using prosthetic devices or limbs, or otherwise in uncomfortable situations.
May have to deal with family of patients.

Skills

Typing (minimum 40 WPM)
Computer data entry
Multitasking
Prioritization
Teamwork
Independent work
Medical office experience
Billing experience
Hospital registration experience
Insurance verification (HMO, MCR, MCD, BC, WC, NF, liability, traditional indemnity)
Professionalism
Sensitivity to cultural and linguistic diversity
Customer service
Initiative
Proactiveness
Collaboration
Courtesy
Respectfulness
Flexibility
Electronic verification tools
Telephone communication
Interpersonal skills
Medical Terminology (desired)
Good office skills (desired)
Professional appearance (desired)
Pleasant personality (desired)
Congenial manner (desired)
Good telephone personality/manner (desired)

Location

WHMC

Work Type

Full-Time
Temporary

Experience Level

1 year job-related experience

Education Level

High School Diploma or equivalent

Salary/Compensations

Hourly Rate: 27.9051

About the Company

Union: 1199