Registration Specialist - Sleep Lab (Days)

Tanner Health•Carrollton, GA

1d•Onsite

About The Position

Facilitates quality and efficient patient intake process through pre-registration, registration, insurance and precertification verification, document completion, scheduling and work output review. Work assignment will include multiple locations within the facility or system, performing various tasks within Sleep Center.

Requirements

High School Diploma or GED
One year of related experience.
Requires a working knowledge of standard practices and procedures.
Excellent public relations skills.
Pleasant professional demeanor when dealing with the public even irate or abusive individuals.
Must possess the ability to communicate effectively and maintain good relations with co-workers, the hospital and medical staff as well as with patients, families, and third-party payers.
Ability to make independent decisions, displaying emotional maturity and using sound judgment
One year of Patient Access experience required.
Ability to interact and work well as a part of a team oriented environment.
Ability to comprehend and apply a large variety of operating procedures.
Ability to organize for maximum time utilization, productivity and smooth patient flow.
Ability to work effectively in high stress situations.
Ability to work in fast-paced environment with frequent interruptions.
Proficient use of computer equipment.
Ability to read and write legibly with spelling accuracy.
Exhibit flexibility through availability to work hours and days potentially outside of normal shifts or routines, as needed, based on departmental or system demands.

Nice To Haves

Previous experience or knowledge of ICD-9, CPT-4 coding techniques preferred.
Knowledge of medical terminology preferred.
Prior knowledge of terminology related to polysomnography preferred.

Responsibilities

Enters required patient data in the system, with emphasis on accuracy of demographic data and financial information, thus ensuring appropriate revenue classification, routing & reimbursement.
Reviews all quality edits, exceptions or rejections via registration quality or billing software to reduce or address denials.
Ensures that all pre-certifications authorizations, matching planned services, are completed or updated, within the specified time frames as mandated by the payer's payment authorization protocols and thoroughly documented on the account.
Performs medical necessity check, utilizing accurate payor guidelines and facilitates additional diagnosis order requests where relevant.
Maintains a working knowledge of department and facility policies and procedures.
Displays independent reasoning skills for problem resolution as required within the scope of job assignments.
Will transcribe all referrals into orders that are sent to Medical Director of Sleep Services for Co-sign prior to be scheduled.
Reviews and responds to insurance claims on why a sleep study was performed as a split study. (ie: patients AHI couple with co-morbidities.
Registers patients following department's standards, policies and procedures, focused on consistently efficient throughput and the overall patient experience.
Validates all insurance through the appropriate eligibility system and ensures COB (Coordination of Benefits) validation via the payor response or Medicare Secondary Payor Questionnaire (MSPQ) where applicable.
Ensures managed care payors are entered correctly in the HIS, per the eligibility response.
Reviews data entry to ensure all payor mnemonics utilized, match electronic or phone eligibility obtained to include COB, managed care, coverage types (HMO, PPO, POS, CMO, IP Only, liability etc).
If in a supporting role (ie IP verification, Surgical Verification etc), validates existing payor data from prior registration or pre-registration entry and makes updates revisions appropriately in the account, to ensure a clean claim.
Ensures all registration related signature capture is completed to include consents, regulatory documents, etc.
Ensures all relevant payment liability forms are completed consistently & compliantly, to include Medicare Advanced Beneficiary Notices, Medicaid Advanced Beneficiary Notices, Waiver of Liability forms etc.
Further ensures these forms are delivered before services are rendered, with focus on the patient experience.
Enters data & comments in the designated HIS fields, to permit timely and accurate follow up, ensuring documentation of financial activity, clearance, etc.
Timely and accurately scans all necessary insurance information including insurance cards, personal ID, driver's license, eligibility & authorization validation, etc.
Assist with timely order inventory processing by consistently indexing orders from order management system.
Creates patient estimates based on scheduled or walk in services, using current charge master pricing info, coupled with the eligibility response.
Reviews developed estimates with patients, to ensure understanding.
Consistently focuses on maximizing resources and time, to ensure expeditious patient throughput and account processing.
Proactively solicits peers and leaders, offering assistance to avoid non-productive or downtime periods.
Exhibits a culture of operational excellence through personal ownership in individual and departmental process efficiency, quality and outcomes.
Completes statistical gathering and reporting as directed.
Demonstrates a positive attitude toward all THS customers and projects a positive professional image.
Maintains proficiency of technical skills in all areas of the department as necessary to assume duties of call rotation as required.
Maintains confidentiality of all patient data and medical information.
Distinguishes and responds correctly to certain disaster or emergency situations such as fire alarm, visitor injury, etc.
Will Assist with the Scheduling of patients for services when necessary.
Ensures they are aware of verbiage that is specific to Polysomnography including but not limited to: 1. CPAP 2. Split-Night 3. HST 4. AHI 5. Sleep Apnea
Will review patient's medical history and make educated decision on if additional accommodations or need for a caregiver are required.
Completes EPIC training and on-going competency as needed or required by accrediting agencies.
Assures patients are correctly scheduled at appropriate locations based on patient criteria and staffing.
Assures patient to staffing ratio is correctly scheduled.
Performs other tasks as assigned.
Employee performs within the prescribed limits of Tanner Health System's Ethics and Compliance program.
Is responsible to detect, observe, and report compliance variances to their immediate supervisor, the Compliance Officer, or the Hotline.