Patient Registration Representative

CommonSpirit Health•Merced, CA

14h

About The Position

As our Representative, Patient Registration, you will play a crucial role in ensuring a positive patient experience while facilitating the essential registration process. Every day, you will employ excellent customer service skills to guide patients through registration, ensuring a positive experience from their first interaction. Your primary duties involve accurate patient identification, collecting thorough demographic data, obtaining and verifying insurance information and benefits, and determining and collecting patient financial liability. You will be responsible for referring patients to the Patient Registration Specialist as needed for financial counseling or clearance, adhering strictly to organizational policies for resolving patient financial liability. To be successful in this role, you will possess proven experience in patient registration, customer service, or a related administrative role, preferably within a healthcare setting. You will demonstrate exceptional interpersonal and communication skills, capable of empathetically handling patient inquiries and confidently explaining complex financial and policy information. Meticulous attention to detail, accuracy in data collection, and a strong understanding of insurance verification and patient financial responsibilities will be essential in ensuring appropriate reimbursement and a smooth patient journey. Employing excellent customer service skills, the Patient Registration Representative is responsible for ensuring a positive patient experience throughout the registration process.

Requirements

Minimum 1 year of experience working in a hospital Patient Registration department, physician office setting, healthcare insurance company, revenue cycle vendor, and/or other revenue cycle-related roles and Experience in requesting and processing financial payments, or applicable education and/or training can be used to balance a lack of experience
Thorough understanding of insurance policies and procedures
Working knowledge of medical terminology
Able to perform basic mathematics for payment calculation
Intermediate to advanced computer skills

Nice To Haves

Knowledge of charity programs as well as the various government and non-government programs

Responsibilities

Appropriate patient identification
Collecting accurate and thorough patient demographic data
Obtaining insurance information and verifying eligibility and benefits
Determining and collecting patient financial liability
Referring patients to the Patient Registration Specialist as needed for assistance with financial counseling and/or clearance
Maintains up-to-date knowledge of specific registration requirements for all areas, including but not limited to: Main Admitting, OP Registration, ED Registration, Maternity, and Rehabilitation units.
Ensures complete, accurate and timely entry of demographic information into the ADT system at the time of registration
Properly identifies the patient to ensure medical record numbers are not duplicated.
Responsible for reviewing assigned accounts to ensure accuracy and required documentation is obtained and complete.
Meet CMS billing requirements for the completion of the MSP, issuance of the Important Message from Medicare, issuance of the Observation Notice, and other requirements, as applicable and documenting completion within the hospital's information system for regulatory compliance and audit purposes.
Follows approved scripting, verifies insurance benefits on all patients registered daily by using electronic verification systems or by contacting payers directy to determine the level of insurance coverage.
Thoroughly and accurately documents insurance verification information in the ADT system, identifying deductibles, copayments, coinsurance, and policy limitations.
Obtains referral, authorization and pre-certification information; documents this information in the ADT system and submits notices of admission when necessary.
Verifies medical necessity check has been completed for outpatient services. If not completed and only when appropriate, uses technology tool to complete medical necessity check and/or notifies patient that an ABN will need to be signed.
Identifies payer requirements for medical necessity.
Verifies patient liabilities with payers, calculates patient's payment, and requests payment at the time of registration.
Understands and follows the Delay/Defer procedure and escalates accounts that do not meet financial clearance standards to Patient Registration leadership immediately.
Explains the Payment and Billing Assistance Program to all patients regardless of financial concerns or limitations.
Refers patients to Patient Registration Specialist as appropriate.
Documents the referral to the Patient Registration Specialist in the ADT system.
Provides financial clearance services to self-pay patients prior to discharge or within 24-business hours.
Acts as resource to other hospital departments regarding insurance benefits and requirements and collaborates with other departments, as needed, to ensure proper compliance with third party payer requirements.
Properly handles credit card transactions in accordance with PCI-DSS standards and guidelines.
Will have access to both single card transactions as well as access to data from multiple transactions or reports and files containing bulk transactional information containing un-encrypted or un-redacted credit card information.
If required by facility, inventories and stores patient's valuables following proper procedure.
Works with physician offices and clinical areas to collect and share patient information and to help update these stakeholders on changes in Patient Registration requirements, processes or programs.
Understands and follows the Cashier policy and procedures.