Registration Coordinator

Responsibilities

• Communicates LPPHC administrative and financial policies clearly to patients, answering patient account questions and knowing when to refer patients to financial counseling, billing partners, patient relations or other support departments for additional help.
• Obtains and documents insurance authorizations for established patient visits, referrals and procedures or ancillary services.
• Communicates clinical information from medical records authorization requests to insurance companies.
• Works RFI work queues to secure information for accurate billing submissions or to respond to denials such as retro authorizations, clinical documentation, and addended authorizations with add on CPT codes.
• Secures prior authorization for procedures, specialty visits and ancillary testing and coordinates with Hospital Admissions Department as needed.
• Collects and verifies insurance and referral/authorization information for first appointment ensuring referral records and Hospital Accounts Records (HARS) are created and assigned to the appointment.
• Secures complex insurance authorizations for services, medications, or testing and is able to track the authorizations for renewal based on insurance company driven limits of time frames or numbers of visits or services.
• Understands how to identify and interpret a patient’s insurance benefit package, including pharmacy and mental health carve outs.
• Addresses patient complaints from patients regarding billing and complaints related to billing that come out of Patient Relations.
• Understands the concept of managed care and is knowledgeable about the resources available to the staff in regard to knowing the specific requirements of individual managed care plans.
• Affords assistance to patients to understand the concept of managed care.
• Manages patient expectations by providing Mental Health-specific guidelines related to service/visit.
• Obtains appropriate consents, PAFRs and signed documents at first visit.
• Creates a professional and positive first impression for patients and referring physicians.
• Demonstrates good judgement and common sense.
• Maintains and adheres to patient confidentiality and HIPAA guidelines including the distribution of NOPP (Notice of Privacy Practices) and PAFR (Patient Financial Responsibility form).

Qualifications

• One year related experience.
• Bachelor's degree in related area and/or equivalent experience/training.