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Manhattan, KS 66502
Under direction, responsible for the time of service registration processing of registration department patient accounts. This responsibility includes: collect/validate/update the patient’s comprehensive data set and documenting in the registration system, complete electronic insurance verification, identify managed care issues and refer as appropriate for resolution, obtain appropriate signatures to satisfy legal and health system requirements and complete required forms including Medicare MSP, if required, financial education and finalization of financial resolution with patients, complete additional registration admission, discharge, transfer and scheduling functions as applicable and resolving edit failures following established policies and procedures.
These activities are completed following established policies and procedures, and in compliance with Joint Commission, Medicare, Payer contracts, HIPAA, regulatory agencies and the organization’s Code of Conduct.Essential Duties and Responsibilities include the following. Other duties may be assigned. Customer Service:
+ Supports and upholds the organization’s philosophy of customer service.
+ Exhibits a positive attitude with a professional and pleasant demeanor when communicating with all customers and providing information.
+ Consistently uses diplomacy and respect both in person and when using the telephone, and performs effectively and professionally under stressful conditions.
+ Ensures customer concerns are processed in compliance with organization’s policies while maintaining the highest level of patient and employee rights, including confidentiality of patient information and personnel issues.
+ Recommends organization and departmental improvements based on appropriate customer concerns.Teamwork:
1. Attends and participates at departmental team meetings, work-groups and other organizational educational programs.
2. Accommodates and supports the changes required to meet departmental and organizational goals and customer needs.
3. Works effectively and cooperatively in groups/teams to continuously improve the process within which he/she works.Communication/Interpersonal Relationships:
+ Establishes productive working relationships with those contacted in the course of work.
+ Ensures necessary data, identified processing issues and related information is provided to departmental management, appropriate departments and individuals within the organization in a timely manner.
+ Exhibits a professional and pleasant demeanor when dealing with patients, employees, third-party payors and other customers of the organization.Financial Viability:
+ Identifies and notifies management of customer service issues and potential process/system problems that cause billing and payment errors and assists in improvement implementation as requested.
+ Determines priority of daily processing work and effectively completes work as assigned.
+ Demonstrates a good working knowledge of all applicable processes within Registration.
+ Identifies and recommends computer system enhancements, computer applications and procedural changes to improve (1) accuracy and timing of claim submissions; (2) accuracy of third party payer and patient payments; (3) customer relations, and (4) efficiency of operations.Personal Development:
+ Attends internal and external seminars for personal growth and development and shares pertinent information with other team members.
+ Completes the annual mandatory in-services and other conditions of employment requirements.
+ Reads and comprehends correspondence from government and third-party payors to keep abreast of new regulations, policies and billing and payment requirements.Quality:
+ Detailed understanding of all technical primary and secondary billing rules and policies and procedures for assigned third party payors and contracts.
+ Understands the Medical and Clinical services provided by the organization.
+ Assists with the revision or development of the department’s internal documents, procedural manuals and forms, as requested.
+ Answers questions from other staff or clinic offices by phone or e-mail in a timely manner.
+ Consistently and accurately documents accounts with activities as needed in a timely manner. Includes admission, transfer, discharge and scheduling functions.
+ Timely resolves edit failures following established policies and procedures
+ Informs management of any known or suspected violations by other employees or suppliers.
+ Welcome all customers in a friendly manner and offer assistance by giving directions or escorting patients to service areas.
+ Understand and follow the Stormont-Vail confidentiality policy, always maintaining the confidentiality of patients, co-workers, volunteers and physician offices.
+ Using information available, correctly identify patient’s point of access, welcome patient and ensure patient is directed to the appropriate location in a timely manner.
+ Collect and verify the accuracy of patient demographic information with patient or family members at the time of registration.
+ Collect and update the comprehensive data set and validate information with patient prior to patient arrival for services.
+ Determine estimate of charges when appropriate and calculate patient liability for scheduled service.
+ Identify insurance sources, collect and document detailed and accurate insurance information in a timely manner.
+ Identify and complete Medicaid and charity screening, when applicable.
+ Copy patient insurance cards and explain insurance benefits as appropriate.
+ Complete electronic insurance verification for all participating payers using an electronic eligibility system.
+ Obtain physician orders/instructions and contact physician office and/or other hospital department to resolve access issues as necessary.
+ Identify managed care provisions and follows up with appropriate parties to resolve outstanding issues.
+ Negotiate financial resolution through proper sequencing of resolution options and patient’s ability/willingness to pay.
+ Following established guidelines, obtain appropriate signatures to satisfy legal or health system requirements and complete required forms including MSP screening.
+ Collate all information and paperwork required for service department use. (Examples consist of armbands, consents, face sheets/data sheets, etc.).
+ Explain patient information and obtain proper signatures as appropriate (i.e., advanced directives, patients rights, authorization for treatments).
+ Screen registrations for sensitive diagnosis and obtain special release according to established hospital policy.
+ Complete scheduling of clinic appointments as applicable.
+ Recognize volunteers as team members by delegating meaningful duties and demonstrating appreciation for their service.
+ Understand and abide by the organizational code of ethics.
+ Accurately collect and document payments received in a timely manner.
+ Accurately post payments according to payer cash processing and reconciliation procedures.