Admitting Representative - Er Registration - Full Time/Days - Req# 1946440489

Brief Description

Job Objective:

Under the direction of the Department Supervisor or other designee provides a variety of patient welcoming and access services in support of the Admitting/Registration areas. Pre-registers and registers patients presenting at the hospital for inpatient, outpatient and emergency services. Conducts patient/guarantor interviews, explains hospital policies, patient financial responsibilities and patient's bill of rights. Facilitates the patient registration/admission flow, including activities such as patient identification, identification of accurate demographic and insurance information, and collection of required signatures and documents. Responsible for the verification of insurance benefits on all inpatient and outpatient accounts through electronic verification system or through contact with third party payors, in order to obtain accurate and prompt reimbursement. Checks eligibility, benefits, authorization requirements, PCP approval requirements, and billing requirements, as appropriate. Submits notice of admission to payors, as needed. Collects co-payments, and other patient liabilities. Enters the financial and admissions data into the hospital information computer systems.

Duties and Responsibilities:

• Uses a legal signature on all admission forms
• Obtain, verify and correct demographic information, select correct guarantor and emergency contacts on all registrations/pre-admissions
• Collects all co-pays and deductibles at the time of registration/pre-registration
• Explains all admission forms accurately and understandably and direct patient and or responsible party to initial and sign were applicable on all forms
• Explains Advance Directives and direct patients to their MD for completion of form
• Completes Medicare Secondary Payer form correctly
• Uses military time on all admission forms
• Uses proper patient identifiers when selecting the patient record into the hospitals ADT systems as outlined in the facilities policies and procedures
• Completes registrations/pre-admissions without creating a duplicate medical record number
• Advance Directives and Patient Information
• Organization of daily activities
• Explains the Medicare Rights form to patients that this form applies
• Completes registrations\pre-registrations with correct Primary Care MD, Admitting MD and Attending MD
• Understands chart placement of all forms
• Registration/Pre-registration
• Monitors and coordinate work daily to achieve maximum productivity and efficiency
• Provides patients and their families with assorted required documents to assist them during their stay
• Ensures that all required insurance authorizations are obtained at the time of registration/pre-registration
• Chooses the correct patient type as indicated by MD order or pre-admit order and the current registration systems
• Forms Completion
• Review all work for quality at the end of each shift and make corrections if necessary
• Provides all required information such as Patient Rights and Responsibilities, Speak up Brochure and use of blood at the time of registration
• Understands the purpose of the Patient Responsibility form in regards to Core Measures and the timely completion of the form and Smoking Cessation information
• Ensures that all insurance verifications are obtained at the time of registration/pre-registration

Non-Essential Duties:

• Accepts and carries out all other miscellaneous clerical and/or administrative duties and responsibilities as required for maintaining all services provided by Admitting Services
• Other duties as assigned, within skill sets and abilities
• Obtains insurance verification on all required patient accounts as outlined in the department’s policies and procedures
• Ensures insurance authorizations are received and documented in the patients account as required by insurance carriers

Knowledge, Skills and Abilities:

Knowledge

• Knowledge of medical terminology
• Knowledge of multiple insurance plans and authorization procedures and processes for obtaining payment
• Knowledge of basic arithmetic
• Knowledge of Microsoft Office applications
• Knowledge of HMO, PPO, Commercial, and Workers’ Compensation reimbursement

Skills

• Skilled usage of MS Office applications
• Use of the use of a calculator
• Good analytical and problem-solving skills
• Excellent interpersonal skills and strong customer focus
• Strong communication and organizational skills
• Good planning, time management and decision-making skills
• Skilled in usages of computers and programs in a hospital setting
• Use of basic personal computer
• Proficient in the operation of scanners, copiers, and fax machines

Abilities

• Ability to handle stress
• Ability to read and understand insurance requirements
• Ability to read handwritten and transcribed documents in the medical record, interpret information,
• Ability to maintain a working relationship with other departments within the organization
• Ability to verify and interpret insurance benefits and collect co-pays
• Ability to manage a heavy caseload in an organized and efficient manner
• Ability to maintain an accuracy rate of 98% or higher relating to all registration/preadmission/bed control activities within the Patient Access departments
• Ability to enter complete and accurate data into the facilities computer systems

Core Competencies: All AVH employees will effectively demonstrate these behaviors:

• Teamwork
• Ethics & Values
• Action Oriented
• Accountability
• Integrity & Trust
• Customer Focused
• Effective Communication
• Compassion

Education and Experience:

Education

• High School graduate or equivalent

Experience

• Insurance follow-up experience in an acute care setting preferred
• 1-year recent experience in an Admitting Department in an acute care setting preferred. Will consider 1-year experience in a medical office or hospital Business Office setting
• Previous Commercial, HMO, PPO, and Workers Compensation billing

Required Licensure and/or Certifications:

• None

AVH Conduct/Compliance Expectations:

• Conforms with required and appropriate JCAHO requirements
• Ability to expand on own initiative in performance of duties
• Ability to adhere with AVH Leaves of Absence Policy
• Ability to adhere with AVH Recording of Hours Worked Policy
• Conforms to AVH Standards of Excellence
• Ability to follow the Code of Business Conduct (Standards of Business Ethics and Integrity)
• Ability to adhere with AVH Absenteeism and Tardiness Policy
• Safely and effectively uses all equipment necessary to carry out duties
• Ability to maintain the confidentiality of patient, hospital and department information
• Ability to organize work and establish priorities
• Ability to adhere with AVH Paid Time Off (PTO) Policy
• Display a willingness to work as a team player
• Skill and ability to follow the telephone etiquette/standards
• Ability to function effectively under pressure and meet time parameters
• Ability to communicate effectively while maintaining good working relationships with co-workers, managers and other hospital staff
• Ability to participate effectively in department and hospital staff education
• Ability to give and support the highest level of patient/customer satisfaction at all times
• Ability to interpret and function under hospital and department policies and procedures
• Supports and adheres to the values and mission statement established by the AVH Board of Directors
• Ability to demonstrate knowledge and understanding of Corporate Compliance rules and regulations, complies with duty to report behavior standard, demonstrates understanding of purpose for Corporate Compliance hotline and importance of seeking guidance from a supervisor when in doubt regarding a possible corporate compliance issue
• Ability to adhere to safety rules and regulations
• Conforms with and supports hospital quality assurance and improvement guidelines
• Ability to adhere to the department dress code
• Ability to adhere to the normal standards of courtesy and conduct as defined under the rules of hospitality at AVH

Physical Requirements and Working Conditions:

• Primarily works in a climate-controlled area
• Tolerate repetitive arm and hand movements
• Frequent Sitting and standing for long periods of time

A detailed description of the physical requirements of this job is maintained in the Employee Health Department.

Requirements

Education and Experience:

Education

• High School graduate or equivalent

Experience

• 1-year recent experience in an Admitting Department in an acute care setting preferred. Will consider 1-year experience in a medical office or hospital Business Office setting
• Previous Commercial, HMO, PPO, and Workers Compensation billing