Provides intermediary customer service coverage, registration, and admitting in any point of service specialist areas and is responsible for patient information and insurance intake. Assigned intermediary duties include, but not limited to: appointment scheduling, registrations, direct admissions, insurance verifications, authorization notifications, multi-line telephone coverage, data entry, filing protected health information (PHI), referrals/physician orders, collections, and financial estimates, while maintaining quality patient/customer relations.
This is the second of three job levels that provide customer service, registration, and/or admissions to an assigned point of service area. The different levels of this job family are distinguished by the skills and experience required to perform the accountabilities, the complexity of problems solved as part of the job and the assigned level of responsibility.
Accountabilities
1. Promptly fields and responds to inquiries providing information to patients, patient families, other hospital departments, and medical staff according to established policies for CMC.
2. Answers telephone in a courteous and professional manner.
3. Provides proficient customer service skills by greeting and treating all patients and staff with respect and discretion.
4. Gathers and/or verifies all appropriate patient demographics, injury information, and financial information, including: insurance benefits, co-pays, deductibles, and financial programs.
5. Identifies and armbands patients correctly.
6. Performs Admissions, Direct Admissions, and bedside registrations for procedures and treatments.
7. Obtains all appropriate signatures: COA, HIPAA, etc.
8. Scans photo ID, insurance cards, COA, HIPAA, financial documents, etc. into hospital information system.
9. Establishes payment source through online verification system, insurance website, or phone call to insurance company. Determines appropriate insurance plan, financial class, and insurance guarantors required for billing.
10. Notifies insurances, within their specified time frames, for authorizations.
11. Holds sufficient understanding of insurance protocols for co-payments, deductibles, allowances, etc. Analyzes information received to determine patients’ out-of-pocket liabilities.
12. Sufficient knowledge of CMC's contracted vs. non-contracted insurance payors.
13. Performs estimates through hospital information system and informs patient of their financial responsibilities.
14. Collects upfront payments toward patient’s financial responsibilities. Handles daily deposits and balance cash drawers.
15. Ensures that all information is complete and accurately entered into the health information system.
16. Knowledge of federal, state, and local agencies requirements in order to meet regulatory compliance for documents as well as refer patients appropriately.
17. Performs other job-related duties as assigned.
Knowledge, Skills and Abilities
• Advanced clerical and customer service standards.
• Standard knowledge of current policies and procedures and regulatory compliance.
• Proven knowledge of Medical Terminology obtained from previous work experience or class.
• Advanced skills in data entry.
• Correct English usage in spelling, grammar, punctuation, and vocabulary.
• Read and comprehend office or program instruction manuals and reports.
• Compose and use proper formats for a variety of correspondence, reports, instructions, and other documents.
• Proficient customer service skills with the ability to deliver friendly and efficient customer service to all patients, visitors, and staff.
• Ability to multi-task and use critical thinking skills for problem solving in a high demanding environment.
• Proficient with MS Office applications (e.g., Excel, Word, etc.).
• Sufficient knowledge of third party payers, including: federal, state, and private health plans.
