Patient Registration Rep

R1 RCM•Round Rock, TX

18h•Remote

About The Position

R1 is the leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry’s most advanced technology platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our Patient Registration Representative, you will be responsible for creating required insurance authorizations on behalf of the responsible physician’s office for scheduled patients. Direct patient contact may be required to secure patient’s information such as demographics and insurance information, which is needed to determine patient’s eligibility, coverage, and authorization requirements. Representatives will understand payer requirements and have the ability to read and understand clinical information to support the patients need for care. Success in this role is measured with the use of weekly productivity scorecards.

Requirements

High School diploma or equivalent
Excellent customer service skills exhibiting good oral and written communication skills
Ability to type fast and accurately
Must be able to communicate effectively and professionally to our patients and physician offices
Basic Microsoft Word and Excel
Ability to multitask and prioritize
Must be self-motivated

Responsibilities

Initiates contact with client hospital patients via telephone using appropriate scripting to ensure the patient’s medical record is current with details such as demographics and insurance information, as needed.
Initiates contact with insurance companies via website, fax, or telephone using appropriate scripting to ensure the required level of benefit and pre-certification/authorization requirements are obtained.
Communicates with other departments as needed for order accuracy and completion.
Utilizes hospital EMR systems to obtain clinical information.
Creates timely insurance authorizations on behalf of the responsible physician office.
Effectively coordinates Peer to Peer discussions between Clinicians and Insurance companies.
Provides superior customer service to all patients, works through patient-raised issues, and recommends appropriate solutions.
Maintains organized, detailed summaries of prior authorization requests to support post-claim denial workflows.
Complete appropriate electronic forms with detailed benefit and authorization information to ensure a clean claim.
Identifies inaccurate plan codes and corrects in the hospital’s main frame.
Adheres to the guidelines set forth in the Health Insurance Portability and Accountability Act (HIPAA), designed to prevent or detect unauthorized disclosure of Protected Health Information (PHI).