Admissions Specialist I - Avera Specialty Hospital

Avera Health•Sioux Falls, SD

36d•$18 - $23•Onsite

About The Position

Responsible for registering patients in a timely and accurate manner while performing all necessary procedures to establish accounts and medical record numbers. The Admissions Specialist verifies insurance coverage and limitations and collects patient co-payments, deductibles and out-of- pocket expenses and communicates this to the patient. The Admissions Specialist completes insurance verifications, pre-certification and/or authorization for assigned accounts.

Requirements

The individual must be able to work the hours specified.
To perform this job successfully, an individual must be able to perform each essential job function satisfactorily including having visual acuity adequate to perform position duties and the ability to communicate effectively with others, hear, understand and distinguish speech and other sounds.
High School or GED Equivalent

Nice To Haves

Healthcare experience
1-3 years related experience in billing, insurance or registration

Responsibilities

Performs all necessary procedures to create accounts/medical record number and insurance coverage and limitations in a timely and accurate manner as well as coordinates communication with patients, employees, providers, and external financial agencies.
Registers patients in a timely and accurate manner by entering demographic, insurance, physician, and other defined information while following established registration standards; assists Patient Care staff with bed assignments based on patients diagnosis, age, and condition; assists in monitoring the quality and efficiency of the registration process including completing follow-up on incomplete registrations through bedside registration.
Strives to meet Point of Care collection initiative by generating patient estimates, educating patients at the time of service and/or pre-calling on their individual plan benefits and identifying specific account goals for collection based on deposit matrix/patient estimator tools. Requests and accepts deposits towards deductible and/or coinsurance amounts from patients based on current deposit matrix/patient estimator tools and posts payments correctly to the payment processing system.
Maintains customer relations at a very positive level as evidenced by feedback from patients, visitors, physicians, patient care units, and fellow employees. Ensures all patients are offered a Patient's Rights Brochure, understands the admission consent form, and have been informed of the hospital's privacy practices (HIPAA).
Coordinates internal hospital messages, imports continuity of care documents (CCDS) and answers telephone promptly and courteously and immediately addresses caller's needs. Completes insurance verification, pre-certification/authorization for assigned accounts.
Interacts with the patient while in Patient Care units in order to complete registration (obtaining consents, inform patients of telephone consumer protection act, insurance information, referring physicians, and CMS required documentation) such as IMMs, MOON, and OBVs, etc.
Checks for medical necessity by confirming CPOM order and status of care at time of admission for direct admits.