Patient Representative | Registration | 2nd Shift | Memorial Health

Memorial Health Ohio•Paris Township, OH

11d•Onsite

About The Position

We are looking for a Patient Representative to join our collaborative team at Memorial Health! This role involves performing patient registration, gathering essential demographic and financial information, verifying insurance, and ensuring all necessary forms and documentation are completed accurately. The Patient Representative plays a crucial part in the financial effectiveness of the hospital by managing insurance details and identifying accident-related encounters. They also ensure patients receive appropriate forms and understand their rights and responsibilities. Additionally, this role requires verifying insurance eligibility and benefits, securing prior authorizations, and managing medical necessity verifications for certain services. Accurate patient identification and the prevention of duplicate medical records are key responsibilities. The role also involves notifying clinical departments of patient arrivals and delays.

Requirements

Completion of High school diploma or equivalent.
Personal computer/data entry experience preferred.
Six months working in the healthcare environment preferred.
Experience with Microsoft Word, Excel and Outlook preferred.
Strong telephone and interpersonal communication skills.
Teambuilding skills.
Knowledge of medical terminology and medical insurance preferred.
Excellent customer service skills.
Attains American Heart Association’s BLS certification within first sixty (60) days of employment and maintains continuous certification.
Attends Behavioral Health De-escalation Training Class within six months of hire.

Nice To Haves

Personal computer/data entry experience
Six months working in the healthcare environment
Experience with Microsoft Word, Excel and Outlook
Knowledge of medical terminology and medical insurance

Responsibilities

Performs registration for various areas including Memorial Hospital, City Gate MOB (Urgent Care), Jerome MOB (Central Registration and Urgent Care), and Urbana MOB (Central Registration and Urgent Care).
Conducts interviews with patients to gather demographic, financial, and guarantor information, travel screenings, and MyChart activation, while inputting data into the Hospital Information System (HIS).
Obtains and/or reviews insurance cards (Medicare, Medicaid, third-party) and patient photo identification to contribute to the financial effectiveness of the Hospital.
Identifies patient’s veteran status and documents their intention to bill the Department of Veteran Affairs, notifying the pre-cert specialist or ensuring proper VA authorization is on file.
Identifies accident-related encounters and corrects claim, guarantor, and coverage details.
Secures patient or patient representative signatures on required forms such as consent to treat, financial policy, patient rights and responsibilities, HIPAA notice of privacy practices, Provider Based Billing Acknowledgement, Notice of Non-Coverage, and notice of non-discrimination.
Provides appropriate forms to patients, including Animal Bite Forms and First Report of Injury (FROI).
Completes verification of patient insurance plan eligibility and benefits using the Hospital-based eligibility system and/or web-based technologies.
Verifies that prior authorization/precertification is secured for required outpatient testing and procedures, documenting within the EMR.
Completes medical necessity verification for Medicare outpatient tests and services with LMRP/LCD in place, requests additional information from physician offices if needed, and presents an Advanced Beneficiary Notice (ABN) if necessary.
Correctly identifies patients using three primary identifiers, avoids duplicate medical records (DMR) creation, and reports duplicate MRNs when discovered.
Notifies clinical departments of patient arrivals and delays.