Admitting Representative

Job Summary:

As an Admitting Representative at Ahmc Healthcare, you will play a vital role in ensuring the smooth registration process for patients. Your primary responsibility will be to verify financial sponsorship, patient demographics, and insurance eligibility, utilizing your knowledge of department and hospital policies and procedures.

Key Responsibilities:

1. Verify financial sponsorship, patient demographics, and insurance eligibility during and prior to the registration process.
2. Notate all registration activity in the adt/ms4 registration system.
3. Quality control all patient data, checking for accuracy, on all registrations.
4. Notify physicians' offices and patients of any deductibles and/or co-pays prior to and after registration.
5. Collect and notate deductibles, co-pays, and cash packages during and prior to registrations.
6. Verify and enter appropriate insurance plan codes and financial codes.
7. Pre-admit and verify all pertinent patient data prior to patient arrival when possible.
8. Work in various areas, including ER registration, pre-admissions, and registration, with a willingness to work flexible hours.
9. Interview patients to compile, verify, and update all pertinent information necessary to complete IP, OP, and Pre-Admit registrations, birth certificates, claims, billing, or other health information patient access information related.
10. Assure that patient information is accurately obtained and documented, informing patients of Federal and State Healthcare Regulations and explaining hospital policies and procedures.
11. Complete admission forms, prepare identification bands, and label them. Confirm patient identification, place bands on the left or right wrist or other extremity, according to diagnosis.
12. Using labels, emboss admission forms for placement on patient charts. Update face sheets and distribute forms to appropriate departments as directed.
13. Secure direct admits verification assignments with the cooperation of the Bed Control RN or Nursing Supervisor for incoming patients.
14. Review and adhere to the medical staff suspension list and follow hospital protocol when accepting patients, referring suspended physicians to the appropriate Administrator-On-Call.
15. Record and place patient valuables in the safe.
16. Communicate with the Utilization Review Department regarding possible transfers or problems.
17. Know, use, maintain, verify, reconcile, correct, balance, and audit various health information/patient access indexes, lists, reports, accounts, census, logs, computer, and optical imaging storage and retrieval systems. Compile and generate information related to same.
18. Obtain patient signatures and witness all consent forms according to Federal and State regulatory agencies.
19. Successfully communicate information to patients regarding the Health Information Privacy and Portability Accessibility Act (HIPAA) and document accordingly within the CPSI System that patient has acknowledged receipt of their privacy rights and notice.
20. Successfully communicate information to patients regarding Advance Care Directives and document accordingly.
21. Have knowledge of third-party payers, including commercial, HMOs, PPOs, EPOs, Capitation, and Worker's Compensation. Demonstrate knowledge of Federal (Medicare) and State (Medi-Cal) payers and basic diagnosis criteria to differentiate Inpatient and Outpatient admissions and provide optimum insurance selection for successful reimbursement.
22. Verify managed care requirements and/or insurance information using electronic verification technology as appropriate.
23. Obtain authorizations for treatment via telephone, electronic, or written documentation as needed by meeting 24-hour notification requirements of carriers.
24. Successfully communicate information to patients regarding their insurance benefits.
25. Request, collect, and document appropriate deposits, deductibles, and copays from patients or by contracting family or guarantor as needed to secure the account.
26. Demonstrate computer literacy, including basic knowledge of hospital computer systems, including PC Windows environment, insurance verification software, optical imaging software, electronic mail, printers, scanners, and other office computer hardware.
27. Ability to accurately understand, pronounce, and spell basic Medical Terminology.
28. Assist with the training of new employees when requested.
29. Complete cross-training in all access areas, including Main Admissions, Emergency Room, and Pre-Admission and Insurance Verification.
30. Independently complete shared departmental projects in a timely manner (for example, pre-registrations, scanning, etc.).
31. Display sensitivity to the patient's condition in extracting information and assuring maximum confidentiality.
32. Answer the phone promptly and provide assistance to all callers in a helpful and efficient manner.
33. May perform special assignments and/or other duties as assigned or delegated by Lead, Supervisor, or Department Director.
34. Cashiering duties and ability to collect and post payments to CPSI as well as balance and reconcile daily logs for cash collections.
35. Perform other relative duties as assigned or required.

Qualifications:

High school graduate or equivalent. Previous registration, insurance, medical office experience preferred. Knowledge of medical terminology. Knowledge of computer input and skills. Good communication and guest relation skills. Current MAB Certification.