Admitting Rep, Part time - Evenings

University of Chicago Medicine•Harvey, IL

11d•Onsite

About The Position

Join Ingalls Memorial Hospital as an Admitting Representative at our Harvey, IL Location. .In this position, you will be assisting patients with their registration needs. This department is known for their dedication to customer service. We ensure that each patient has a positive experience with us. This position, under the supervision of the Admitting Supervisor and Admitting Manager, is responsible for the daily duties inherent in the registration, pre-registration of medical, surgical (Outpatient Registration, Emergency Department and Pre Admission Services) process as defined by the hospital procedures. Job Functions Promptly fields and/or directs incoming calls, responds to patient and/or staff inquiries with resolution or escalation Ensures all registration and admission forms are presented to and verified by patient/guarantor before signing; Ensuring patients/guarantor understand what is being signed Practices proficient customer-service skills by greeting and treating all patients and staff with respect and discretion Gathers and verifies all appropriate, confidential health and financial information from patients while using various computer software to assure payment for all authorized services Enters new patient data and/or verifies patient records are up-to-date, confirms the completeness of the electronic health record (EHR),makes changes as necessary, and files records in accordance with Ingalls Memorial hospital’s filing system Complies with all organizational, state, and federal laws and registrations related to patient privacy and confidentiality, such as the Health Insurance Portability and Accountability Act (HIPPA) Verifies insurance eligibility and benefits immediately for non-emergent cases and no later than end of shift for emergent cases., and obtains pre-authorizations from third-party payers in accordance with payer requirements Verifies medical necessity in accordance with Centers for Medicare & Medicaid Services (CMS) standards and communicates relevant coverage/eligibility information to the patient Identifies patients who will need Medicare Advance Beneficiary Notices (ABNs) of non-coverage and maintains accurate records of authorizations within the EDM Holds sufficient understanding of insurance protocols for referrals, co-payments, deductibles, allowances, etc., and analyzes information received to determine patients’ out-of-pocket liabilities Responsible for understanding the general principals of Medicare and the Medicare Important Notice Guidelines as published by CMS in the final rule CMS-4105-F Responsible for identifying via the system the Medicare and Medicare Advantage members admitted to the facility as an inpatient admission Will have direct patient contact with our patients and/or their family members and must have the ability to multi task and explain the Medicare form so the patient and/or family understand their rights as a Medicare beneficiary Will be responsible for scanning all documents in the appropriate document type in the hospital system Must engage with Case Management and Utilization Review on a frequent basis due to potential patient handoffs as directed by the policy Will be required to lift boxes (up to 30 pounds) and at times help with transporting patients

Requirements

1-2+ years of demonstrated Clerical/ Administrative Customer Service experience
1-2+ years of demonstrated professional Customer Service/Clerical experience it relates to a hospital environment
Typing requirement (minimum 25-30 wpm)
Experience in the basic computer software programs
Must poses strong written and verbal communication skills
Requires good analytical and problem solving ability
Demonstrated ability to develop others in areas of continuous process improvement, and customer service, Delivery and self-directed team work
Requires maturity and ability to appropriately represent the department to other internal and external customer strong commitment to the development of staff

Nice To Haves

Medical Terminology knowledge
Previous experience in a health care environment, preferably, Admitting, Emergency Department, or Physician’s office or other related health care experience is desired
Knowledge of Medicare
Knowledge of HMO and PPO (what are the differences)

Responsibilities

Promptly fields and/or directs incoming calls, responds to patient and/or staff inquiries with resolution or escalation
Ensures all registration and admission forms are presented to and verified by patient/guarantor before signing; Ensuring patients/guarantor understand what is being signed
Practices proficient customer-service skills by greeting and treating all patients and staff with respect and discretion
Gathers and verifies all appropriate, confidential health and financial information from patients while using various computer software to assure payment for all authorized services
Enters new patient data and/or verifies patient records are up-to-date, confirms the completeness of the electronic health record (EHR),makes changes as necessary, and files records in accordance with Ingalls Memorial hospital’s filing system
Complies with all organizational, state, and federal laws and registrations related to patient privacy and confidentiality, such as the Health Insurance Portability and Accountability Act (HIPPA)
Verifies insurance eligibility and benefits immediately for non-emergent cases and no later than end of shift for emergent cases., and obtains pre-authorizations from third-party payers in accordance with payer requirements
Verifies medical necessity in accordance with Centers for Medicare & Medicaid Services (CMS) standards and communicates relevant coverage/eligibility information to the patient
Identifies patients who will need Medicare Advance Beneficiary Notices (ABNs) of non-coverage and maintains accurate records of authorizations within the EDM
Holds sufficient understanding of insurance protocols for referrals, co-payments, deductibles, allowances, etc., and analyzes information received to determine patients’ out-of-pocket liabilities
Responsible for understanding the general principals of Medicare and the Medicare Important Notice Guidelines as published by CMS in the final rule CMS-4105-F
Responsible for identifying via the system the Medicare and Medicare Advantage members admitted to the facility as an inpatient admission
Will have direct patient contact with our patients and/or their family members and must have the ability to multi task and explain the Medicare form so the patient and/or family understand their rights as a Medicare beneficiary
Will be responsible for scanning all documents in the appropriate document type in the hospital system
Must engage with Case Management and Utilization Review on a frequent basis due to potential patient handoffs as directed by the policy
Will be required to lift boxes (up to 30 pounds) and at times help with transporting patients