LEAD REGISTRATION REPRESENTATIVE

Job Description

Job Description

1

POSITION DESCRIPTION

JOB TITLE: Lead Registration Representative

DEPARTMENT: Front Office

REPORTS TO: Office Manager

FLSA STATUS: Nonexempt

CREATED DATE: 5/14/10

REVISION DATES:

POSITION SUMMARY

KEY RESPONSIBILITIES

This position performs lead registration representative functions for the front-office operation and acts as back-up to the Office Manager in his or her absence. The Lead Registration Rep provides general oversight of assigned teams and works in a lead capacity and ensures superior service throughout department. The lead serves as liaison to patients, physicians, and administration to process problems, changes, feedback and workflow relative to Patient Registration operations. The lead position also gathers and records required information about patients; which includes screening for financial eligibility, confirming health insurance coverage and individual obligations, obtaining necessary authorizations for care, scheduling appointments, and assisting patients in a clinic setting. Responsible for greeting and assisting patients entering health care centers by registering new patients; entering pertinent patient data and account information; ensuring data is current and accurate; obtains third party coverage information and photocopies health insurance information; or other applicable healthcare coverage.

1. Manages and coordinates all aspects of patient registration and pre-registration, scheduling, insurance verification, patient medical records, and financial counseling functions; ensure that all aspects of these functions support optimal patient and provider satisfaction.

2. Serves as a Lead for Patient Registration; supervises personnel which includes work allocation, training, and enforcement of internal procedures and controls, and problem resolution; motivates employees to achieve peak productivity and performance.

3. Maintains effectiveness of patient flow, Oversee the daily activities of the registration area to insure department standards are met. Maintain QA statistics and report results to Site Manager, provides and supports ongoing recommendations for optimization of front-end processes in response to ever changing reimbursement rules, regulation and implement such changes as directed. Monitor and secure all signatures necessary for treatments, release of medical information, and assignment of insurance benefits and payment of services from legally responsible patients.

4. Assists Site Manager in educating registration staff of any changes pertinent to their roles, and develops procedures and trains staff on new systems. Assists with orientation of new staff.

5. Act in capacity of Site Manager in his/her absence, and inform Site Manager of all issues upon return. Serves as a primary contact for Site Managers relating to technical areas.

6. Excel in all functions performed by patient access representatives, register all patient types; when appropriate serve/function as Patient Registration Representative

Customer Service:

7. Provides high quality customer service to both external customers (patient, referring providers, and insurance carriers) and internal customers (health care providers and staff) that meets or exceeds the service standards of the health care industry.

2

8. Greets patients; family members; and customers in a positive and welcoming manner.

9. Answers telephone calls and provides adequate assistance to callers.

10. Checks patient into the clinic via the electronic record to acknowledge the patient has arrived for an appointment or is requesting to be evaluated; and to generate a visit record for the patient.

11. Ensures compliance with HIPAA and HITECH standards.

12. Inputs ticket requests for facility maintenance; property; and Healthcare Technology as needed into the electronic system.

Enrollment:

13. Gathers and verifies patient information including data entry of information into an electronic data base; actively verifies correct identity of patient using at a minimum two (2) patient identifiers (full name; date of birth; last four numbers of social security number; mother’s maiden name; Certificate of Indian Blood and/or tribal enrollment number; or other identified patient specific, unique identifiers).

14. Actively obtains and verifies pertinent and accurate patient registration information i.e., demographic; emergency contact; any alternate healthcare coverage; etc.

15. Confirms patient eligibility for health care coverage and clarifies any managed care arrangements.

16. Enters all information accurately into electronic databases or into the medical record when necessary.

17. Obtains third party coverage information by collecting and photocopying health insurance cards i.e., Medicaid; AHCCCS; Medicare; or other applicable healthcare coverage.

18. Obtain signatures for required documents.

19. Initiates prescreening for all patients with no alternate resources for potential eligibility under Medicaid, Medicare, etc. Works closely in identifying all alternate resources available, such as OTP: Sliding Fee Discount Program, Prenatal Care Discount Program, A Step Ahead, Tennessee Breast & Cervical Screening Program, Ryan white Program, etc.

20. In the event of claim information discrepancy or denial; incumbent determines the source of discrepancy or reasons for denial and implements corrective action as appropriate to ensure that the claims can be processed for payment.

Infection Control, Safety & CMS:

21. Adheres to established Hand Hygiene Standards.

22. Adheres to Universal Precautions and Infection Control protocols.

23. Reports safety issues or concerns to Safety Officer, Security, or Site Manager of the clinic.

Supply Functions:

24. Organizes, inventories, orders, and maintains clerical supplies forms, and other documents needed for the clinic.

25. Performs other duties as assigned.

3

JOBS THIS POSITION DIRECTLY SUPERVISES

The Lead Registration Representative provides back-up supervision of the following jobs in the absence of the Office/Clinic Manager.

Job Title

Number of Incumbents

Front Desk/Registration Clerks

3

Click here to enter text.

Click here to enter text.

POSITION REQUIREMENTS

Education: High school diploma or equivalent

Experience: Minimum of three years experience as a medical office assistant; working knowledge of computers; proven communication and customer service skills.

Licenses or Certifications: N/A

Mental Requirements

Level 1 – Requires some concentration and normal attention. Generally, once the job is learned, the tasks can be performed more or less automatically.

X

Level 2 – Requires high periods of concentration intermittently and normal attention. Generally, even once the job is learned, tasks will require normal attention to deal with recurring variables.

Level 3 – Requires a high level of concentration and high level of attention intermittently. Generally, the approach to tasks may be consistent, but the number of steps required and/or the number of variables involved creates the possibility of errors unless the incumbent pays close attention.

4

Physical Requirements

Activity

Approximate % of Time

Comments

Sitting

60%

Standing

20%

Walking

20%

100%

Approximate percentage of time spent lifting, pulling and/or pushing: 20%

Maximum number of pounds required (with or without assistance): 10 lbs.

Types of objects the incumbent is required to lift/pull/push. Files, charts

Machines and Equipment Used:

Machines, Equipment, Tools

Approximate % of Time

Degree of Hand:Eye Coordination Required

1. Photocopy machine

20%

Normal

2. Fax machine

10%

Normal

3. Credit card machine

20%

Normal

4. Computer

90%

High

Choose an item.

Approximate percentage of time incumbent spends in “on-the-job” travel, excluding commuting to regular work location: N/A

Working Conditions

Typical office environment with some exposure to patients who may be infectious

OTHER REQUIREMENTS

My signature below indicates I have reviewed and understand the key responsibilities and requirements for the position.

Employee’s Printed Name: _______________________________________________________

Employee’s Signature: __________________________________________________________

Date: ________________________________________________________________________