Coord,Quality Control(Admit)PD

MemorialCare•Laguna Hills, CA

1d•Onsite

About The Position

This position requires the full understanding and active participation in fulfilling the mission of Saddleback Medical Center. It is expected that the employee demonstrate behavior consistent with our core values: Integrity, Accountability, Best Practices, Compassion and Synergy. The employee shall support Saddleback Medical Center’s strategic plan and participate in and advocate performance improvement/patient safety activities. The Quality Control Coordinator works under the direction of the Manager of the Admitting department and is responsible for reviewing admissions and registrations (Inpatients, ER visits, Outpatient Bedded, and Ancillary visits) to ensure account accuracy. The QC Coordinator must be able to multitask, with emphasis on detail essential, while utilizing daily system logs as a method of identifying and documenting registration errors. The QC Coordinator needs to communicate professionally and courteously while providing feedback, education, and training to the team. The QC Coordinator will correct and update patient demographics and financial information. Identifies trends, potential problems and conducts additional training when necessary. Must have a strong insurance verification background. They must be knowledgeable in coverages and the authorization process, including an understanding of insurance contracts. Must be able to prioritize job duties to ensure volumes are met. Must be familiar with the hospital’s EMR and system. The QC Coordinator promotes a positive team environment and maintains effective working relationships with co-workers, patients, and management.

Requirements

2 or more years of experience in Admitting, insurance verification, medical business office or equivalent healthcare experience preferred.
Strong customer service skills.
Ability to communicate effectively and clearly in both written and verbal form.
General knowledge of insurance payors: PPO, HMO, POS, EPO, Medicare, Medi-Cal, & Cal-Optima.
Positive work ethic.
Computer skills required including: electronic medical record and Microsoft Office.
Knowledge of medical terminology.

Nice To Haves

High School Graduate preferred
Medical Terminology related course or certificate preferred

Responsibilities

Ability to correct all registration errors and update information timely and accurately.
Ability to calculate and collect any unmet deductible, copay, and coinsurance.
Knowledge of Commercial plans, IPA’s, Medicare, Workers Comp, Medi-Cal, and Cal-Optima.
Ability to interpret and advise patients of their financial responsibility (copay, coinsurance, deductible).
Monitors and manages workqueues daily.
Ability to role model outstanding customer service skills using “Simply Better” and AIDET principles.
Ability to communicate effectively in written and verbal form.
Serves as a knowledgeable resource to the staff.
Educates and in-services staff on their errors.
Ensures all registration forms are complete, signed and within the patient’s encounter in Epic. Enters notes in Epic as required.
Ability to interact in a positive and constructive manner.
Ability to be at work and be on time.
Ability to follow company policies, procedures and directives.
Ability to interact in a positive and constructive manner.
Ability to prioritize and multitask.