Admissions Specialist

Avera•Aberdeen, SD

8d•Onsite

About The Position

The Admissions Specialist registers patients accurately and promptly, completing the procedures needed to establish patient accounts and medical record numbers. The role verifies insurance coverage and limitations, completes insurance verification and pre-certification or authorization for assigned accounts, and communicates expected patient costs. It also collects and correctly processes deposits and patient payments, coordinates registration communications, and supports patient care staff with bed assignments and follow-up registrations. The position interacts with patients in hospital care units to complete registration and required documentation, while maintaining positive customer relations and protecting patient confidentiality. This position is based at Avera St. Luke’s Hospital and works rotating days, evenings, nights, weekends, and holidays. The listed shifts are 7:00 a.m.–3:30 p.m., 8:00 a.m.–4:30 p.m., 11:00 a.m.–7:30 p.m., 1:00 p.m.–9:30 p.m., and 2:30 p.m.–11:00 p.m.; the employee may be asked to cover any shift. The schedule is 48 hours per pay period.

Requirements

High school diploma or GED equivalent.
Ability to work the specified hours and shifts.
Visual acuity adequate to perform position duties.
Ability to communicate effectively, hear, understand, and distinguish speech and other sounds.
Ability to perform the essential job functions satisfactorily.
Commitment to Avera’s mission, vision, core values, and social principles; uphold its CARE standards of Communication, Attitude, Responsiveness, and Engagement.
Work effectively in a team environment and maintain confidentiality.

Nice To Haves

Healthcare experience.
One to three years of related experience in billing, insurance, or registration.

Responsibilities

Create patient accounts and medical record numbers and enter insurance coverage and limitations accurately and promptly.
Coordinate communication with patients, employees, providers, and external financial agencies.
Register patients by entering demographic, insurance, physician, and other required information according to established standards.
Assist Patient Care staff with bed assignments based on patients’ diagnoses, ages, and conditions.
Monitor registration quality and efficiency and follow up on incomplete registrations, including bedside registration.
Generate patient estimates, educate patients about their plan benefits, and identify account collection goals using deposit matrices and patient estimator tools.
Request and accept deposits toward deductibles or coinsurance and post payments correctly to the payment processing system.
Maintain positive customer relations with patients, visitors, physicians, patient care units, and fellow employees.
Offer patients a Patient’s Rights Brochure, explain the admission consent form, and inform them of hospital privacy practices under HIPAA.
Coordinate internal hospital messages, import continuity of care documents (CCDs), and answer telephone calls promptly and courteously while addressing callers’ needs.
Complete insurance verifications and pre-certifications or authorizations for assigned accounts.
Complete registration with patients in Patient Care units, including obtaining consents and insurance and referring-physician information, informing patients about the Telephone Consumer Protection Act, and completing required CMS documentation such as IMMs, MOONs, and OBVs.
For direct admissions, check medical necessity by confirming the CPOM order and status of care at admission.
Maintain confidentiality and coordinate workflow effectively with team members.
Comply with applicable safety principles, laws, regulations, and standards, including CMS, The Joint Commission, DHHS, and OSHA requirements.