Registration Specialist (69774)

About the Role

The Registration Specialist ensures efficient and accurate loading of patient registration information into the OCHIN Epic system prior to the patient’s scheduled appointment. This role requires meticulous attention to detail, strong organizational skills, and a preferred understanding of Oklahoma FQHC billing requirements. The specialist collaborates with operations, billing, EHR Support Analysts, and other administrative professionals to streamline workflow and enhance patient care delivery.

Character First Qualities:

• Decisiveness – The ability to recognize key factors and finalize difficult decisions.
• Dependability – Fulfilling what I consented to do, even if it means unexpected sacrifice.
• Initiative – Recognizing and doing what needs to be done before I am asked to do it.
• Thoroughness – Knowing what factors will diminish the effectiveness of my work or words, if neglected.
• Flexibility – Willingness to change plans or ideas without getting upset.

Responsibilities

• Proficient understanding of insurance Medicare, Medicaid, and Commercial requirements.
• Completes chart audits of insurance and revenue cycle requirements, including EPIC data entry and required FQHC documents prior to patient appointments, and communicates findings to leadership as needed.
• Proficient in understanding Revenue Cycle Management, the impact of insurance benefits on patient care, and patient balances.
• Expert in telephonic registration, accuracy of data entry, and verification of benefits to ensure clean claims and accurate billing, reducing denials and errors.
• Supports compliance requirements as an FQHC, including but not limited to Sliding Fee Scale (SFS), Proof of Income, and other key financial documents.
• Complete insurance verification 3-5 days prior to appointments and place electronic verification notes in Epic accurately and timely.
• Clearly communicates required documents needed at the time of patient check-in.
• Performs batch and individual eligibility verification using the Insurance Eligibility (IE) function in Epic or other insurance portals as needed.
• Submits electronic insurance verification through Epic, insurance website portals, or by calling insurance companies to inquire about eligibility, benefits, and payment for services.
• Maintains knowledge of all contracted insurances and programs accepted at Variety Care.
• Provides direct support to clinics regarding eligibility inquiries.
• Ensures accurate insurance eligibility, benefits, and financial information for billing and collection processes.
• Completes a high volume of benefit verification requests.
• Refers PCP changes to Clinic Administrator, provider, and operations director when needed.
• Informs patients, if needed, of their PCP, benefits, and financial responsibility.
• Works closely with sites, insurance carriers, and patients.
• Applies Sliding Fee Discount Program (SFDP) discounts as necessary and ensures Declaration of Income documentation is captured.
• Provides customer service internally and externally with professionalism, courtesy, knowledge, and follow-through.
• Functions at the highest level according to eligibility competency.
• Upholds Medicare, Medicaid, and HIPAA compliance guidelines related to billing, collections, and PHI information.
• Follows written and verbal instructions from the Manager of Revenue Cycle Management.
• Participates in special projects.
• Supports Variety Care’s accreditation as a Patient-Centered Medical Home and commitment to providing care that is Safe, Effective, Patient-Centered, Timely, Efficient, and Equitable.
• Works to achieve the goals of the “Triple Aim” of healthcare reform: improving the experience of care, improving health outcomes, and decreasing healthcare costs.
• Embodies personal character, values open and honest communication, and displays high moral and ethical conduct, integrity, adaptability, and sound judgment.
• Serves as a leader in the department and community, acting as a result-oriented problem solver who is responsible and accountable.
• Maintains up-to-date knowledge of the healthcare industry through participation in local and national associations, review of publications, development of personal contacts, and continuing education seminars.
• Fosters an atmosphere that promotes quality service to Variety Care patients and internal customers through active involvement, attention to detail, and personal responsibility for patient care and business outcomes.
• Conveys, communicates, and interacts effectively with all levels of management and staff to coordinate special projects and foster good working relationships that further Variety Care’s goals and objectives.
• Performs other duties as assigned.

Requirements

• Proficient understanding of Medicare, Medicaid, and commercial insurance requirements.
• Minimum of 2 years of work experience in a similar or related position, such as registration and/or medical billing.
• Proficient understanding of Revenue Cycle Management and its relation to patient care and patient balances.
• Proficient understanding of insurance eligibility, plans, and benefits.
• Excellent communication and organizational skills.
• Computer experience and competency in data entry and business applications.
• Direct experience working with the public in a customer service role, either in retail or over the phone.
• Attention to detail and accuracy; motivated self-starter.
• Excellent customer service skills and ability to handle difficult situations.
• Critical thinking skills to assess and resolve complex patient accounts.
• Strong work ethic and commitment to improving patients’ lives.
• Flexibility and adaptability with a drive to go above and beyond.
• High school diploma or equivalent.
• Expert in telephonic patient service and registration.

Preferred Qualifications

• Excellent knowledge of Epic system usage.
• Familiarity with insurance payers and funding sources, including managed care plans.
• Proficient with MS Office (Word, Excel, and Outlook).
• Understanding of medical billing terminology, claim processing, and different insurance health plans.
• Enthusiastic, ability to work efficiently in a fast-paced environment, and follow through on processes.