Representative - Admissions Services

Job Title

Network Operations Center

Category

Patient Services

Shift

Night

Department

Network MG Reg/Sched Float Pool

Qualifications

• 6 months medical office, hospital registration/business/banking/medical insurance office/customer service experience. Required
• 1 year experience at a medical office or other hospital/ nursing home facility. Preferred

Responsibilities

JOB SUMMARY Admits clients to the hospital, which includes collecting information and deposits, completing forms and obtaining signatures, scanning ID cards/documents, and updating ADT systems. Ensures all patients are efficiently and accurately registered and prioritizes patients during period of high volume.

• Greets patients and the public, providing necessary information in a courteous and professional manner while supporting HIPAA regulations and HonorHealth confidentiality standards. Ensures a positive patient experience by addressing patient questions and concerns in an empathetic and professional manner.
• Processes pre-registered accounts, completes registration and admissions information by obtaining patient demographic, insurance, financial and medical information in accordance to revenue cycle criteria.
• Obtains required signatures on all medical, financial and compliance documents. Prepares supportive paperwork, including patient identification band to assure accurate patient identification in accordance with Red Rule Policies.
• Scans all appropriate documents into the electronic medical and financial record, including patient identification, insurances cards, patient advanced directives, Conditions of Admissions, Financial Agreements, physician orders/scripts and any other pertinent paperwork.
• Responsible for adhering to all third party payer requirements including Medicare, Medicaid, managed care, Blue Cross and commercial plans. Verifies insurance eligibility and coverage and executes appropriate insurance notification procedures. Obtains prior authorization in order to avoid non-compliance, denials and/or penalties to the patient, hospital and physician(s). Initiates notifications to insurances as required. Checks for medical necessity and follows appropriate procedures depending on results. Keeps supervisor and/or lead informed of all unique situations and problem accounts.
• Requests and accepts payments for balances due on accounts upon admission or at the time of discharge, including patient co-payment, deductible, and co-insurance responsibilities and pre-payments for uninsured or underinsured patients.
• Collaborates within the multi-disciplinary health care team to facilitate and ensure patient satisfaction and maximization of reimbursement. Helps with department training when needed.

Education

• High School Diploma or GED Required

Experience

• 6 months medical office, hospital registration/business/banking/medical insurance office/customer service experience. Required
• 1 year experience at a medical office or other hospital/ nursing home facility. Preferred

License and Certifications

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