As the initial contact to the department/clinic, uses personal skills to quickly build a positive relationship with persons served. Creates a welcoming environment for persons served. Demonstrates the ability to effectively manage details by accurately completing registration, verifying payer coverage, processing orders/referrals, maintaining medical records and completing billing procedures. Effectively manages positive relationships with referral sources and other members of the team. Positive impact on patient flow and processes to streamline access to care for patients.
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Processing Orders/ Referrals/ Patient Registration
• Processes therapy orders accurately
• Obtains accurate information from referring physician or family during intake procedures.
• Accurately and completely obtains patient information in regard to demographics and insurance to register the patient
• Objectively and effectively communicates at a personal and professional level.
• Exhibits exceptional communication skills in working with a variety of individuals to create rapport and obtain information for accurate registration.
• Manages up the clinic and professional staff to alleviate patient/family anxiety and confidence in the care received.
• Coordinates with providers and patient/families regarding appointment scheduling
• Handles phone calls in professional and timely manner to enhance communication for patients/families and providers.
Verifying/ Managing Payor Coverage/ Billing
• Verifies insurance benefits with insurance companies and checks for required pre-certification. Able to answer questions regarding CPT codes and diagnosis coding.
• Communicates to patient/family regarding payment. Knowledgeable of various insurance policies, co-payments, and hospital deductions.
• Handles telephone calls concerning patient benefits or estimated costs promptly.
• Communicates with third party payers to assure payment (i.e.: sends medical records promptly, etc.)
• Understands and complies with billing and reimbursement procedures according to governmental and third-party requirements.
Additional Projects
• Assists with departmental projects including data collection, project pilots, patient engagement.
• Other duties as assigned.
Compliance
• Reports any questions or concerns regarding compliance immediately to the attention of department or organization/hospital administrative staff.
• Utilizes a family-centered approach (considering physical, psych/social, spiritual, educational, safety, and related criteria) appropriate to the age of the patients served.
• Shows responsible and accountable management of human, fiscal, and material resources.
• Accepts responsibility for maintaining and developing personal and professional skills and knowledge related to the work area assigned.
• Demonstrates initiative to improve quality and customer service by striving to exceed customer expectations.
• Balances team and individual responsibilities; open and objective to other’s views; gives them welcome feedback; contributes to positive team goals; and puts the success of the team above own interests.
Other functions performed on an as needed basis:
• This position may be assigned a specific mission to address in an emergency situation to assist in disaster response and recovery as part of the Hospital Emergency Incident Command System. Situations of a critical nature may require an individual to perform multiple tasks until additional support can be obtained.
• Performs functions other than described due to extenuating circumstances.
Education:
• High school graduate or equivalent.
• Must read, write, speak and comprehend English.
• Must be able to communicate effectively (written and orally) with people of diverse professional, educational and lifestyle backgrounds.
Experience:
• Must have working knowledge of Microsoft products and Outlook. Must be flexible to learn additional IT applications as assigned.
• Two years billing/financial counselor experience or health care related experience preferred.License(s)/Certification(s):
• Valid driver’s license when driving any vehicle for work-related reasons.
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