PRE-REGISTRATION SPECIALIST
About The Position
Under the direction of the System Manager of Patient Access, Pre-Processing, Pre-Registration Specialist collects information to preregister patients, verifies insurance and/or other payment sources for all outpatient-related services, including same day procedures and other ambulatory and hospital-based outpatient services. Identifies and determines order of priority for coordination of benefits (COB). Responds to customer concerns and reports status to Supervisor or Manager. The pre-registration specialist's role helps to avoid implications of incomplete preregistration/insufficient staffing. Such implications include, but are not limited to, inability to locate the patient file in the system and/or submit a request for pre-certification, non-submission of claims for processing, and payment discounts and/or timely filing denials.
Requirements
- High School diploma or GED equivalent is required. (Must provide proof at time of interview)
- Three (3) years of experience in patient access or patient registration in a health care setting is required.
- One (1) year of data entry experience is required.
- Knowledge and understanding of Federal, State and local healthcare regulations
- Knowledge of Microsoft Office Suite, registration and eligibility system
- Strong customer service and empathy skills
- Demonstrates good computer and typing skills
- Demonstrate good phone and email etiquette skills with strong response times
- Excellent verbal and written communication skills necessary to communicate with all levels of staff and a patient population composed of diverse cultures and age groups
- Strong mathematical skills
- Ability to follow HIPAA standards and comply with patient confidentiality policies
- Ability to prioritize, plan, and organize projects and tasks
- Ability to multi-task and meet quotas and deadlines in a fast paced and stressful environment
- Ability to adhere to department policies and standards utilizing best practices
- Ability to make competent professional judgments and decisions
- Understanding of the formal and informal organization structure
- Demonstrates a desire and willingness to maintain and upgrade professional skills and education
- Demonstrate analytical and organizational, problem-solving, critical thinking, and conflict management/resolution skills
- Demonstrate attention to detail, accuracy, and precision
Nice To Haves
- Prior call center experience is preferred.
Responsibilities
- Utilizes electronic reports and/or schedules to identify patients needing to be preregistered for admission and same day surgery, in addition to any outpatient and/or ancillary services
- Contacts patients via telephone to preregister at least 5-7 days prior to schedule appointments
- Completes initial screening of self-pay patients to determine eligibility for financial assistance of hospital-based outpatient services
- Acquires all essential demographic and insurance information needed for processing and pre-registration purposes
- Identifies procedures that require pre-certification and subsequently notifies the appropriate department.
- Utilizes eligibility vendor, or other electronic communication media to verify benefits
- Identifies and determines order of priority for coordination of benefits (COB)
- Updates Patient Management System with all insurance coverage updates; classifies the patient account with the appropriate coverage
- Makes appropriate notes documenting the reason patient information may be missing from the file
- Responds to customer concerns in a timely and professional manner and reports all developments or outcomes to System Manager of Patient Access, Pre-Processing
- Answers all incoming phone calls in an efficient and courteous manner
- Adhere to HIPAA standards and complies with patient confidentiality policies for the retention of patient information, handling, distribution or disposal of patient health information
- Adheres to key performance indicators (KPI’s) to meet departmental and organizational pre-registration goals
- Communicates with supervisors, managers, and patients daily; physicians, administrative and clinical staff members occasionally
- Performs other duties as assigned by the department System Manager of Patient Access, Pre-Processing
Benefits
- Medical, Dental, and Vision Coverage
- Basic Term Life Insurance
- Pension Plan and Deferred Compensation Program
- Employee Assistance Program
- Paid Holidays, Vacation, and Sick Time
- Public Service Loan Forgiveness Program (PSLF)
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
