Pre-Admit Registration Specialist - Admitting - Full Time 8Hours Day

POSITION SUMMARY

Under the direction of the Admitting Manager, the Pre-Admit Registration is responsible for interviewing scheduled incoming patients (inpatient, outpatient, and emergency room) to obtain all pertinent data for admission. This includes medical record information, as well as demographic and financial related information. Works with physician office managers to obtain necessary pre-admit information and authorizations. Works with Surgical Admit Nurses to coordinate applicable patients for pre-op visits with the SAN. Communicates with financial Counselors regarding patient’s financial status. Responsible for obtaining all documents required for the admission, including but not limited to, orders, durable power of attorney and authorization. Is responsible for answering all inquiries related to admissions, collects deposits or payments, interacts with the nursing units and ancillary departments, and provides directions to various areas within the hospital.

ESSENTIAL JOB FUNCTIONS AND CORE RESPONSIBILITIES

• Assists in the training of new employees.
• Cross-trained as an Insurance Verifier and able to speak with the patient regarding their financial responsibility for the bill. The pre-admission clerk is responsible to handle financial issues with the patient in the event an insurance verifier/financial counselor is not available.
• Demonstrates awareness and sensitivity to the rights of patients and significant others, as identified within the situation.
• Document any financial arrangements made in the patient’s account notes. Notifies the Admitting Manager or Business Office Manager of all problem accounts that require special attention.
• Explains the admitting process to the patient.
• Functions with an awareness of safety issues and reports unsafe issues appropriately, as identified within the institution.
• It is the responsibility of the Pre-Admit Registration to uphold the highest service standards regarding patient pre-admissions. Acknowledging patients or guests and their requests, offering assistance promptly, cordially, and completely, making patient needs the first priority, exhibiting concern, tact and discretion in all working relationships, promoting unity and teamwork among co-workers and other departments, and appearing professional in dress, grooming and hygiene.
• Must be able to work and be cross trained in all areas of Admitting without difficulty which includes, but is not limited to, Inpatient, Outpatient, Bed Board and Emergency Room.
• Must be familiar with the Hospital layout to direct patients or guests to the proper destination.
• Must be physically able to push a wheelchair.
• Must maintain an account accuracy rate of no less than 85%.
• Must remain informed and compliant with HIPAA, EMTALA, the Fair Debt and Collection Practices Act, Medicare Secondary Payor, and other laws and regulations that govern Patient Financial Services.
• Must remain informed regarding all PPO, HMO, Medicare, Medi-Cal and indigent service programs and requirements for timely processing of claims.
• Patient care is of the utmost priority in all aspects of registration. Must be comfortable with sick patients and able to summon medical assistance when needed. Must be BLS certified each year.
• Performs various other duties, as assigned.
• Responsible for appropriate handling of all confidential information while at work, as well as away from the hospital.
• Responsible for communicating with physician’s offices, Financial Counselors, Surgical Admit Nurses, Business Office and Bed Control to ensure the appropriateness and accuracy of scheduled admissions.
• Responsible for gathering current data on all scheduled patients. All insurance information is collected during the process. Copies of insurance cards and authorizations are obtained for scheduled procedures. Responsible for choosing the correct medical record number.
• Responsible for obtaining orders and ensuring they are on the appropriate record prior to the date of surgery.
• Responsible for understanding and participating in the organization-wide Performance Improvement Program through orientation, education, departmental, and inter-departmental quality control, and quality planning activities.
• Responsible for understanding the Consent form, Advance Directive, and any other forms the patient is required to sign in order to accurately and clearly state the intention of each paragraph. Patients are to be well informed before a signature can be obtained.
• Responsible to ensure patient’s electronic medical record is complete and accurate.
• Verifies insurance coverage and complete pre-certification on all scheduled admissions and outpatient procedures. Has the ability and authority to negotiate with the patient.
• Verifies insurance coverage, including eligibility, benefits, and the necessary precertification requirements. Must be able to determine if patient’s hospitalization presents a financial risk to the hospital or an excessive financial burden upon the patient.

Education Minimum (Required) High school diploma or high school equivalency certificate Work Experience Minimum (Required) • Ability and desire to work consistently under pressure in a hectic, high paced atmosphere. • Medical terminology and spelling accuracy are highly preferred. • Must be able to read and write English without difficulty; must be able to recognize numbers. • Must be able to type 40 words per minute and operate a calculator. • Must possess a high level of communication and interpersonal skills. • Outstanding customer service skills required. • Working knowledge of insurance reimbursement, Medicare, Medi-Cal, HMO and PPO is essential.