Admissions Specialist

Avera•O'Neill, NE

3d•Onsite

About The Position

The Admissions Specialist registers patients accurately and promptly, establishes accounts and medical record numbers, verifies insurance coverage and limitations, and collects and communicates patient financial responsibilities. The role completes insurance verification and pre-certification or authorization for assigned accounts and coordinates communication with patients, employees, providers, and external financial agencies. The position is based at Avera St. Anthony's Hospital and works a day schedule Monday through Friday, 8:00 a.m. to 4:30 p.m., with rotating Saturdays from 8:00 a.m. to 12:00 p.m. The specialist supports patient care operations by assisting with bed assignments and completing registrations in patient care units, including obtaining required consents and documentation. The role also generates patient estimates, educates patients about their plan benefits, requests and processes deposits, maintains positive customer relations, supports hospital communications, and checks medical necessity for direct admissions. The employee is expected to uphold Avera's mission, values, confidentiality requirements, safety standards, and CARE standards for communication, attitude, responsiveness, and engagement.

Requirements

High school diploma or GED equivalent.
Ability to work the specified hours.
Ability to perform the essential job functions satisfactorily, including adequate visual acuity and effective communication; ability to hear, understand, and distinguish speech and other sounds.
Commitment to applying Avera's mission, vision, core values, and social principles and to upholding its CARE standards.

Nice To Haves

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

Responsibilities

Create accounts and medical record numbers and enter insurance coverage and limitations accurately and promptly.
Register patients by entering demographic, insurance, physician, and other required information according to established standards.
Coordinate communication with patients, employees, providers, and external financial agencies.
Assist Patient Care staff with bed assignments based on patients' diagnosis, age, and condition.
Monitor registration quality and efficiency and follow up on incomplete registrations, including bedside registration.
Generate patient estimates, educate patients about plan benefits, and identify account collection goals using deposit matrix or patient estimator tools.
Request and accept deposits toward deductible and coinsurance amounts and correctly post payments 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 admission consent forms, and inform patients of hospital privacy practices under HIPAA.
Coordinate internal hospital messages, import continuity of care documents (CCDs), and answer telephone calls promptly and courteously.
Complete insurance verification and pre-certification or authorization for assigned accounts.
Complete registration with patients in Patient Care units, including obtaining consents, providing telephone consumer protection information, gathering insurance and referring physician information, and completing CMS-required documentation such as IMMs, MOONs, and OBVs.
Check medical necessity for direct admits by confirming the CPOM order and status of care at admission.
Maintain confidentiality, work effectively with team members, and comply with applicable safety principles, laws, regulations, and standards.