Admission Registration Lead-26471

About the role

The Admissions Registration Specialist Lead is responsible for reviewing patient registration for all types of admissions and elective procedures and specimens to ensure patient and guarantor demographic and insurance information is complete and current with each patient visit.

Responsibilities

• Collections, verifies and enters into Epic the patient's demographic, employer, financial, emergency contact, insurance, subscriber and case-specific information, such as referring physician and diagnosis.
• Consistently has patient sign and scan all necessary documents for completion of the admission process; consent, ID, insurance card, MIMS, OBS, COB, etc.
• Consistently and accurately obtains and interpret the patient's insurance benefits and possess the ability to communicate this information accurately to the patient and co-workers.
• Has the ability to determine the patient's financial obligation and communicate this information accurately and with respect to the patient.
• Performs registration functions consistent with Federal, State and Local regulatory agencies and payer requirements, and organizational policies and procedures, including HIPAA privacy and security Regulations, as well as JACHO.
• Understands and is able to communicate coverage-related concepts to the patients, i.e. pre-certification and out-of-network.
• Proficient in navigating their own EPIC WQs, as well as assisting in other team members WQs in order to maximize department’s ability to move performance of registration duties.
• Absolutely ensures the admission notification (NOA) process is performed correctly, ensuring the payment for patient’s inpatient stay is secured.
• Appropriately informs the patients of hospital policies that govern the revenue cycle.
• Minimizes the potential financial risk of patients accounts by discussing with the patient and/or guarantor their financial responsibility for upcoming visits/procedures, past due balances and referral requirements.
• Offers options and negotiates acceptable resolution of estimated patient balance.
• Receives and properly responds to, or directs telephone inquiries from patients, payers, physicians and their staff, internal department and other persons and entities.
• Able to find resolution within the phone interaction satisfactory to the caller and/or having the knowledge when to escalate to their supervisor.
• Interacts and collaborates with numerous departments to resolve issues while also analyzing necessary information that will ensure hospital reimbursement.
• Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Rush University Medical Center’s Organizational Integrity Program, Standards of Conduct, as well as other policies and procedures to ensure adherence in a manner that reflects honest, ethical, and professional behavior.
• Guards to assure that HIPAA confidential medical information is protected.

Qualifications

• High school graduate or equivalent.
• 1-2 years of relevant experience.
• Experience within a hospital or clinic environment, a health insurance company, managed care organization or other health care financial service setting, performing medical claims processing, financial counseling, financial clearance, accounting, or customer service.
• Must have a basic understanding of the core Microsoft suite offerings (Word, PowerPoint, Excel).
• Excellent communication and outstanding customer service and listing skills.
• Basic keyboarding skills.
• Ability to analyze and interpret data.
• Critical thinking, sound judgment and strong problem-solving skills essential.
• Team oriented, open minded, flexible, and willing to learn.
• Strong attention to detail and accuracy required.
• Ability to prioritize and function effectively, efficiently, and accurately in a multi-tasking complex, fast paced and challenging department.
• Ability to follow oral and written instructions and established procedures.
• Ability to function independently and manage own time and work tasks.
• Ability to maintain accuracy and consistency.
• Ability to maintain confidentiality.

Preferred Qualifications

• Associates Degree in Accounting or Business Administration.
• Knowledge of insurance and governmental programs, regulations, and billing processes e.g., Medicare, Medicaid, Social Security Disability, Champus, Supplemental Security Income Disability, etc., managed care contracts and coordination of benefits is highly desired.
• Working knowledge of medical terminology and anatomy and physiology is preferable.