Admitting Representative

Overview Under general supervision and guidelines, obtains and verifies financial sponsorship, patient demographics, and clinical information. Utilizes skills and knowledge of department/hospital policies and procedures to register patients, verify insurance benefits, and collect payments. Works in a team environment and must be able to work independently in all areas of registration, including E.R. registration, insurance verification, pre‑admission, out‑patient registration, and cashier with minimal supervision. Position Title: Admitting Representative, Patient Registration. Job Code: S18432. Department: Patient Registration/Admitting. Reports to: Admitting Director. Salary Grade: Non‑exempt. You are expected to fulfill the Mission of San Gabriel Valley Medical Center and demonstrate behavior consistent with its Core Values, supporting its strategic plan and Performance Improvement Plan (PIP). Position Duties Verifies financial sponsorship, patient demographics, and insurance eligibility during and prior to the registration process. Notates all registration activity in the ADT/MS4 registration system. Quality controls all patient data, checking for accuracy on all registrations. Notifies physician’s office and patient of any deductibles or co‑pays before and after registration. Collects and notates (in ADT system) deductibles, co‑pays, and cash packages during and prior to registrations. Verifies and enters appropriate insurance plan codes and financial codes. Pre‑admits and verifies all pertinent patient data prior to patient arrival when possible. Works where needed, including ER registration, pre‑admissions, and registration; must be willing to work flexible hours. Interviews patients to compile, verify, and update all pertinent information necessary to complete in‑patient, out‑patient and pre‑admit registrations, birth certificates, claims, billing, or other health information access. Assures that patient information is accurately obtained and documented. Informs patients of Federal and State Healthcare Regulations and explains hospital policies and procedures. Completes admission forms, prepares identification band and labels, confirms patient identification, and places band on appropriate extremity per diagnosis. Embosses appropriate admission forms for placement in the patient chart, updates the face sheet, and distributes forms to appropriate departments. Secures direct admit verification assignments with the cooperation of the Bed Control RN or Nursing Supervisor for incoming patients. Reviews and adheres to the medical staff suspension list and follows hospital protocol when accepting patients; refers suspended physicians to the appropriate Administrator‑On‑Call. Records and places patient valuables in the safe. Communicates with the Utilization Review Department regarding possible transfers or problems. Maintains, verifies, reconciles, corrects, balances, and audits health information/patient access indexes, lists, reports, accounts, census, logs, computer and optical imaging storage and retrieval systems; compiles and generates related information. Obtains patient signature and witnesses all consent forms according to Federal and State regulatory agencies. Explains HIPAA to patients and documents receipt of privacy rights and notice in the CPSI system. Explains Advance Care Directives to patients and documents accordingly. Knows third‑party payers, including commercial, HMO, PPO, EPO, Capitation, and Worker's Compensation; understands Medicare and Medi‑Cal; basic diagnosis criteria to differentiate inpatient and outpatient admissions for optimal insurance selection. Verifies managed care requirements and insurance information using electronic verification technology when appropriate. Obtains authorizations for treatment via telephone, electronic, or written documentation to meet 24‑hour notification requirements of carriers. Communicates insurance benefits to patients. Requests, collects, and documents deposits, deductibles, and copays from patients, or contracts family or guarantor to secure the account. Demonstrates computer literacy, including basic hospital computer systems, PC Windows, insurance verification software, optical imaging software, email, printers, scanners, and other office hardware. Accurately understands, pronounces, and spells basic medical terminology. Assists with training new employees when requested. Completes cross‑training in all access areas, including main admissions, emergency room, pre‑admission and insurance verification. Independently completes shared departmental projects in a timely manner (e.g., pre‑registrations, scanning). Displays sensitivity to patient condition when extracting information and maintaining confidentiality. Answers the phone promptly and provides assistance to all callers efficiently. May perform special assignments or other duties as delegated by Lead, Supervisor, or Department Director. Cashier duties: collects and posts payments to CPSI, balances, and reconciles daily cash logs. Performs other related duties as assigned or required. Education / Training / Experience High school graduate or equivalent. Previous registration, insurance, or medical office experience preferred; knowledge of medical terminology and computer input skills. Good communication and guest‑relations skills. Licenses / Certifications Current MAB Certification. #J-18808-Ljbffr AHMC HealthCare