Pre-Registration Representative - Pre-Registration HSD - FT - Day

Stormont-Vail HealthCare•Topeka, KS

2d•Hybrid

About The Position

This position plays a vital part in ensuring patients receive needed care and that insurance billing is accurate with benefit to both the patient and the organization. Duties include, but are not limited to scheduling, insurance verification for benefits and eligibility, completion of prior authorizations/pre-certifications, estimates of patient responsibility and preregistration of the patient for a positive customer experience.

Requirements

High School Diploma / GED Required
2 years Physician office, hospital or payer setting with experience relating to patient registration, patient scheduling, exam or procedure scheduling, prior authorization completion or insurance verification. Required
Knowledge of medical terminology (Required proficiency)

Nice To Haves

Associate's Degree Preferred
Knowledge of MicroSoft Windows applications (Preferred proficiency)
Excellent customer service skills (Preferred proficiency)
Excellent interpersonal & communication skills with the ability to exhibit patience. (Preferred proficiency)
Ability to prioritize and handle multiple tasks (Preferred proficiency)

Responsibilities

Schedules patients for hospital services based upon physician orders. This includes scheduling of complex cases, which require the coordination of multiple resources and determination of need for lab work pre-services. Cancels and reschedules appointments as needed. Works with service departments to coordinate the scheduling of urgent same-day add-ons.
Completes insurance verification which includes determining in or out of network status, verifying insurance eligibility and benefits with the payer, coordinating multiple insurance coverages, identifying insurance coverage when needed and all other activities relating to the review of insurance.
Completes the preregistration of scheduled patients via phone by collecting patient demographics, insurance information, accident information, and verifying insurance coverage with payer, educating patient on when and where to arrive for service and any rules related to arrival.
Completes prior authorizations for identified services. Includes review of medical policies to ensure all criteria is met, the process of completing the prior authorization with the payer and the documentation of prior authorization numbers for inclusion on the claim.
Completes precertification (or “Notice of Admission”) for inpatient and identified outpatient admissions with payers after patient arrival. Includes entry of received information into the electronic record for downstream processes.
Creates estimates for identified services within appropriate timeframes. This includes providing financial education to the patient on anticipated balances and the collection of anticipated balances.
Mentors, orients and provides at-the-elbow training for new staff.
Prepares paper and electronic documents for scanning into Epic.
Answers benefits and eligibility questions from patients, office staff, Case Management, Social Work or any other source.
Reviews incoming faxes and distributes to appropriate departments within the organization.
When requested, reviews standard work and training materials for clarity and accuracy.
Participates in process improvement activities.
Complies with all policies, standards, mandatory training and requirements of Stormont Vail Health
Performs other duties as assigned