Representative - Admissions Services

Responsibilities

• 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.

Requirements

• High School Diploma or GED Required
• Experience: 6 months medical office, hospital registration/business/banking/medical insurance office/customer service experience.
• Experience: 1 year experience at a medical office or other hospital/ nursing home facility.