ESRD Business Ops Coord

Position Details

Department: PCH-MAIN | Dialysis Administration
Category: Administrative Support
Location: Telecommuting
Posting #: 722677
Employee Type: Regular

Position Summary

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.

Position Duties

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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.
  6. 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.
  7. Customer Service.
    • Courteously answers the telephone and the door. Answers all questions in a timely manner. Communicates in person and via telephone.
  8. 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.
  9. Management Feedback.
    • Provides feedback to management regarding work related problems and assists with resolution to provide excellent customer service.
  10. 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.
  11. Administrative Duties.
    • Provides administrative support for the unit including, but not limited to placing supply orders,
    • facilitating communication, as well as copying, faxing and providing electronic
    • documentation.
  12. Performs miscellaneous job related duties as requested.

Phoenix Children's Mission, Vision, & Values

Mission

To advance hope, healing and the best healthcare for children and their families

Vision

Phoenix Children's will be the leading pediatric health system in the Southwest, nationally recognized for exceptional care, innovative research and advanced medical education.

We realize this vision by:

  • Offering the most comprehensive care across ages, communities and specialties
  • Investing in innovative research, including emerging treatments, tools and technologies
  • Advancing education and training to shape the next generation of clinical leaders
  • Advocating for the health and well-being of children and families
Values
  • We place children and families at the center of all we do
  • We deliver exceptional care, every day and in every way
  • We collaborate with colleagues, partners and communities to amplify our impact
  • We set the standards of pediatric healthcare today, and innovate for the future
  • We are accountable for making the highest quality care accessible and affordable

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Position Qualifications

Please review the following qualifications and specify whether you meet each of the requirements listed.
Education
Do you meet this requirement?
1. High School Diploma or equivalent.
Required
2. Associates in Business or related field or combination of education and experience.
Required
Experience
Do you meet this requirement?
1. Two (2) or more years of experience in a health care revenue cycle environment.
Required
2. Minimum of one year of medical registration experience.
Required
3. Experience with HIPAA Privacy Act.
Required
4. Experience with HMOs and other third-party payers within and outside the United States.
Required
5. Experience with related Federal and State programs available to the uninsured.
Required
6. Two years or more of multi-specialty coding experience with CPT/current version ICD/HCPCS/modifier coding for physician professional charges.
Preferred
7. Experience with ESRD dialysis facility.
Preferred
8. AMPFM, Misys, Chartmaxx or Payor Websites platform experience.
Preferred
Special Skills
Do you meet this requirement?
1. Effective verbal and written communication skills, professional demeanor, team player with a customer-focused attitude.
Required
2. Knowledge of Medical Terminology and an understanding of HIPAA privacy laws.
Required
3. Ability to work effectively in a high-volume, fast-paced environment with changing priorities.
Required
4. Analytical skills with strong attention to detail and a high degree of accuracy.
Required
5. Knowledge of ESRD regulations.
Preferred
6. Knowledge about Medicare and Medicaid insurance payors.
Preferred
Physical Requirements & Occupational Exposure/Risk Potential
1. Physical Requirement - Climbing - Occasionally
2. Physical Requirement - Feeling (sensing textures and temperatures) - Occasionally
3. Physical Requirement - Fine Motor Skills (pinching, gripping, etc) - Occasionally
4. Physical Requirement - Hearing - Constantly
5. Physical Requirement - Pushing/pulling - Occasionally
6. Physical Requirement - Reaching - Occasionally
7. Physical Requirement - Sitting - Constantly
8. Physical Requirement - Standing - Occasionally
9. Physical Requirement - Stooping/crouching/kneeling/crawling - Occasionally
10. Physical Requirement - Talking - Constantly
11. Physical Requirement - Walking - Occasionally
12. Physical Requirement - Near Vision - Constantly
13. Physical Requirement - Far Vision - Occasionally
14. Physical Requirement - Use of keyboard, mouse and/or computer equipment - Constantly
15. Physical Requirement - Lift up to 35 pounds without assistance - Occasionally
16. Occupational Exposure/Risk Potential - Inside office environment - Applicable
17. Occupational Exposure/Risk Potential - Airborne communicable diseases - Applicable
18. Occupational Exposure/Risk Potential - Bloodborne pathogens or bodily fluid - Applicable
I have reviewed the qualifications, physical requirements and occupational exposure/risk potential for this position and wish to apply