Patient Registration Rep

CommonSpirit Health•Santa Maria, CA

3d•Onsite

About The Position

The Patient Registration Representative ensures a positive patient experience during registration through excellent customer service. The role identifies patients, gathers accurate demographic information, verifies insurance, determines and collects financial liability, and explains hospital policies and patient rights to patients and families. Accuracy, attention to detail, and strong communication support patient satisfaction and reimbursement. The representative handles registrations across areas including Main Admitting, outpatient registration, Emergency Department, maternity, and rehabilitation. They enter and verify information in the ADT system, confirm patient identity, obtain required signatures and documentation, provide relevant patient handouts, and follow regulatory and downtime procedures. The position also verifies insurance coverage and medical necessity, obtains authorization and referral information, explains and collects patient financial obligations, and arranges payment plans when appropriate. The role supports financial clearance and assistance processes, refers patients to registration specialists as appropriate, and collaborates with hospital departments, physician offices, and clinical areas. It also includes cashiering duties and handling payment card information in accordance with applicable policies and standards.

Requirements

High school diploma in General Studies or GED in General Studies.
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.
Experience requesting and processing financial payments.
Applicable education and/or training may be used to balance a lack of experience.

Nice To Haves

2 years of relevant experience is preferred.

Responsibilities

Maintain current knowledge of registration requirements for hospital areas, including Main Admitting, outpatient registration, Emergency Department, maternity, and rehabilitation.
Enter complete, accurate, and timely demographic and financial information into the ADT system; verify pre-registered accounts and correct errors with patients.
Confirm patient identity and help prevent duplicate medical record numbers.
Review assigned accounts and ensure required documentation is complete.
Meet applicable CMS billing and notice requirements, including MSP, Important Message from Medicare, and Observation Notice requirements, and document completion.
Obtain required patient or guarantor signatures, scan required documents, and provide appropriate patient materials such as patient rights and HIPAA notices.
Follow downtime procedures, including identifying the patient's medical record number, assigning a financial number, and entering information when the ADT system is restored.
Follow EMTALA-compliant registration steps for Emergency Department and Labor and Delivery patients.
Assess self-pay patients for presumptive eligibility and initiate the process when appropriate.
Follow Emergency Department protocols for special cases, including behavioral health holds, sexual assault, domestic violence, child protective services, incarcerated patients, workers' compensation, auto accidents, and animal bites, as applicable.
Monitor and address tasks associated with the Mede/Analytics PAI tool.
Verify insurance benefits using electronic systems or direct payer contact, and document coverage, deductibles, copayments, coinsurance, and policy limitations in the ADT system.
Obtain and document referrals, authorizations, and pre-certification information; submit notices of admission when necessary.
Verify that medical necessity checks have been completed for outpatient services; use available tools or notify patients about required ABNs when appropriate.
Determine and explain patient liabilities, calculate payments, request payment at registration, and address outstanding balances from previous visits.
Set up payment plans when patients cannot pay the full current copayment or previous balance at once; document financial discussions and payment agreements.
Apply patient payments and provide receipts according to department policy; clarify and document the division of financial responsibility when applicable.
Escalate accounts to Patient Registration leadership when required by verification outcomes or a patient's ability to pay.
Comply with HIPAA, PHI, ABN, MSP, EMTALA, and other regulations affecting registration.
Follow Delay/Defer procedures and promptly escalate accounts that do not meet financial clearance standards.
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 hospital departments regarding insurance benefits and requirements and collaborate to support third-party payer compliance.
Follow cashier policies and procedures and handle credit card transactions in accordance with PCI-DSS standards and guidelines.
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 to registration requirements, processes, or programs.