Patient Registration Rep

CommonSpirit Health•Bakersfield, CA

About The Position

The Patient Registration Representative ensures a positive patient experience during registration by identifying patients, collecting accurate demographic information, verifying insurance, determining and collecting financial liability, and explaining hospital policies and patient rights to patients and families. The role requires excellent customer service, careful attention to demographic and insurance details, and strong communication to support patient satisfaction and reimbursement. The representative handles registration across areas such as Main Admitting, Outpatient Registration, Emergency Department, Maternity, and Rehabilitation. Duties include entering and reviewing information in the ADT system, validating patient identity, obtaining required signatures and documentation, providing patient materials, and following downtime and EMTALA-compliant procedures. The position also verifies insurance coverage and medical necessity, obtains authorizations, explains and collects patient financial responsibility, arranges payment plans, and refers patients for financial assistance when appropriate. The representative follows applicable regulatory, privacy, billing, cashiering, and payment-card procedures; provides financial clearance services; collaborates with hospital departments and physician offices; and escalates accounts when needed. The job description notes that listed duties describe the general essential functions and are not an exhaustive account of all work requirements.

Requirements

High school diploma in General Studies or GED in General Studies, or applicable education and/or training that can balance a lack of experience.
At least 1 year of experience in a hospital Patient Registration department, physician office setting, healthcare insurance company, revenue cycle vendor, or another revenue-cycle-related role, or applicable education and/or training that can balance a lack of experience.
Experience requesting and processing financial payments.
Knowledge and compliance with applicable requirements, including HIPAA, PHI, ABN, MSP, EMTALA, and other regulations affecting registration.
Ability to provide customer service, communicate effectively, and accurately handle demographic, insurance, and financial information.

Nice To Haves

2 years of experience in a hospital Patient Registration department, physician office setting, healthcare insurance company, revenue cycle vendor, or another revenue-cycle-related role.

Responsibilities

Maintain current knowledge of registration requirements for Main Admitting, Outpatient Registration, Emergency Department, Maternity, Rehabilitation, and other areas.
Enter complete, accurate, and timely demographic and financial information in the ADT system; verify information with patients and correct errors.
Properly identify patients to prevent duplicate medical record numbers and review assigned accounts for accuracy and required documentation.
Complete and document applicable CMS billing requirements, including MSP forms and required Medicare and observation notices.
Obtain patient or guarantor signatures, scan required documents, and provide appropriate printed patient materials.
Follow downtime procedures, including identifying the patient's MRN, assigning a financial number, manually recording information, and entering it into the ADT system when restored.
Follow EMTALA-compliant registration procedures for Emergency Department and Labor and Delivery patients, including applicable special-case protocols.
Assess self-pay patients for presumptive eligibility and initiate the process when appropriate.
Verify insurance benefits, document coverage details and patient liabilities, and obtain referral, authorization, and pre-certification information as needed.
Verify medical necessity for outpatient services, use the applicable technology tool when appropriate, and notify patients when an ABN must be signed.
Calculate and request patient payments at registration; identify outstanding balances, explain liabilities, arrange payment plans, and document financial discussions and agreements.
Apply payments according to department policy and provide receipts; clarify and document how financial responsibility is divided between providers and insurers.
Escalate accounts to Patient Registration leadership when verification outcomes, financial clearance standards, or a patient's ability to pay require it.
Explain the Payment and Billing Assistance Program to all patients, refer patients to a Patient Registration Specialist as appropriate, and document referrals in the ADT system.
Provide financial clearance services to self-pay patients before discharge or within 24 business hours.
Serve as a resource to other hospital departments on insurance benefits and requirements and collaborate to support third-party payer compliance.
Follow Delay/Defer and cashier policies and procedures and handle credit card transactions in accordance with PCI-DSS standards.
Inventory and store patient valuables according to procedure if required by the facility.
Work with physician offices and clinical areas to collect and share patient information and communicate changes in registration requirements, processes, or programs.