Ensures the efficient and orderly pre-registration, registration, insurance verification and authorization for facility-based procedures. Prepares admission forms, obtains necessary documentation and signatures, and confirms demographic information when the guarantor presents for services. This position is responsible for partnering with families and End Stage Renal Disease (ESRD) facility personnel to ensure coordinated admissions, discharges, and ensures that patient clinic visits are scheduled according to facility policies and regulatory guidelines. This position monitors payor status, Medicare applications and Medicare Secondary Payor status. This position works collaboratively with the quality team to maintain patient lists and statistics. Responsibilities include a variety of administrative and customer service functions to support the apheresis and dialysis facilities.
- Family-Centered care that focuses on the need of the child first and values the family as an important member of the care team
- Excellence in clinical care, service and communication
- Collaborative within our institution and with others who share our mission and goals
- Leadership that set the standard for pediatric health care today and innovations of the future
- Accountability to our patients, community and each other for providing the best in the most cost-effective way.
Obtains and documents demographics and financial information.
- Contacts the patient/parent/responsible party by phone and obtains all current demographic and insurance and employer information, making updates and creating accounts in the appropriate Hospital Information System (HIM) for registration, scheduling, and billing. This includes documenting employer changes within last 60 days and verification of insurance benefits using Emdeon, insurance carrier websites or by phone.
Obtains Authorizations for procedures.
- Obtains all necessary authorizations for scheduled procedures. This includes determining by
- payor which procedures require authorization. Accurately documents all information in the
- appropriate fields and/or account notes.
Provides patient/family counseling regarding individual liability for services.
- Inquires patient account system(s) to identify any previous unpaid liability in PCH system. Provides patient estimates prior to service to assist patients in determining cost of services and options for payment. This counseling includes providing information to patient/guarantor regarding any applicable deductible, co-pay, lifetime maximum, pre-existing condition restrictions, as well as previous unpaid liabilities noted in PCH systems.
Accurately documents in patient account and prioritizes work flow.
- Provides accurate and timely documentation for patient`s accounts explaining activities and
- interactions with family members, staff, and outside sources on behalf of the patient.
- Organizes, prioritizes, and monitors daily work activity to ensure that complete, accurate, and
- compliant pre-registration, registration, billing and family counseling has been performed in a
- timely manner.
Registers and arrives patients into procedure area.
- Arrives patients who present for professional and hospital services that have been pre-registered and collect co-pay and deductible amounts. Obtains all necessary signatures from the guarantor at the time of registration or arrival. Performs registration in appropriate HIS system, verifies insurance coverage, obtains authorization for patients who present for professional and hospital services and have not been pre-registered. Accurately documents all information in the appropriate fields and/or account notes. Maintains accuracy when entering demographic and insurance information in the system.
Maintains positive relationships with all customers.
- Maintains a positive working relationship with patients/guarantors, insurance companies,
- government entities, clinical personnel, co-workers and management to promote teamwork,
- cooperation and a positive public image for PCH.
- Courteously answers the telephone and the door. Answers all questions in a timely manner. Communicates in person and via telephone.
Scheduling and Record Keeping.
- Works within the departments to ensure patients appointments are scheduled according to department and regulatory requirements. Ensures all patients treatments are captured and maintains unit statistics for each department.
- Provides feedback to management regarding work related problems and assists with resolution to provide excellent customer service.
Provides supervision and organization.
- Creates and maintains an organized approach to patient management in the dialysis and apheresis facilities. Supervises unit support staff and assists with unit support orientation and scheduling practices.
- Provides administrative support for the unit including, but not limited to placing supply orders,
- facilitating communication, as well as copying, faxing and providing electronic
- Performs miscellaneous job related duties as requested.