Greets patient/family members and obtains/verifies demographic, clinical, financial and insurance information in the process of registering patients for service delivery. This process includes benefit verification, notification and collection of patient liabilities, collection of patient signatures on all appropriate forms, and the imaging/copying of registration documents. May provide escort or directional support to patients, family members, and visitors. Duties should be performed while enhancing the patient experience throughout all interactions, the majority of which will be in person.
1. Actively demonstrates the organization's mission and core values, and conducts oneself at all times in a manner consistent with these values.
2. Knows and adheres to all laws and regulations pertaining to patient health, safety and medical information.
3. Ensures patient safety and maintains integrity of Electronic Master Patient Index by authenticating patient identity throughout all essential functions. Ensures the patient is properly identified and has on armband prior to leaving registration area.
4. Meets or exceeds established customer service, productivity, and quality standards in all essential functions.
5. Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Trinity Health's Organizational Integrity Program, Standards of Conduct as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior. This includes all government notices and other payer notices.
6. Completes entire registration process and maintains departmental objective for accuracy by validating/obtaining all required demographic, clinical, financial and insurance information in the registration computer system. Activities may occur in multiple locations, including patient access points of service, ancillary departments, patient nursing units, the Emergency Department as well as via telephone.
7. Ensures insurance card copies, consent forms and other required paperwork is documented in the patient's electronic medical record.
8. Ensures all patients are checked in, in a timely manner, following specific departmental procedures. Ensures patients have a valid physician order prior to registering the patient.
9. Utilizes and validates information from multiple internal and external computer sources, such as various payers, Patient Access and Patient Accounting systems, or other healthcare providers, to ensure data accuracy. This includes performing insurance eligibility/benefit verification utilizing a variety of mechanisms, primarily Electronic Data Interchange transactions, payer web access and, in some cases, calling payers directly and documenting that information in the registration system.
10. Informs patient/guarantor of their liabilities and collects appropriate patient liabilities including co-payments, co-insurances, deductibles, and deposits prior to or at the point of registration. In collection of funds, documents payments in the patient accounting system and provides patient with a payment receipt.
11. Provides pricing estimates and communicates pre-service patient liability based on expected charges from price guide or Financial Counselor, and potential coverage, as requested.
12. Performs bed control functions that relate to multiple patient types (Inpatient Admission, Outpatient Observation, Bedded Outpatients, Diagnostic Outpatients, Emergency Department) to ensure status is correct against the physician order for compliance and payment purposes.
13. Validates medical necessity to ensure clinical and financial clearance. Contacts scheduling, physician office and/or ancillary department staff for clarification on diagnosis and/or test(s)/procedure(s) as necessary. Presents patient with Advanced Beneficiary Notice or waiver if medical necessity conditions are not met.
14. Resolves account, system, and technology issues within the department and collaborates with other departments to resolve issues, using the help of the Resolution Center when necessary.
15. Provides information, directions, transportation within the facility and assistance to patients, family members and visitors, ensuring timely, customer-centric service delivery. Communicates with various ancillary departments to ensure smooth patient flow and high data integrity.
16. Meets or exceeds productivity standards and during low patient volume times in service areas, actively seeks other duties to meet departmental needs. 17. May serve as relief support, if the work schedule or work-load demands assistance to departmental personnel. May be chosen to serve as a resource to train new colleagues. Cross-training in various functions is expected in order to assist in the smooth delivery of departmental services.
18. Performs other duties consistent with purpose of job as directed.
JOB SPECIFICATIONS AND CORE COMPETENCIES
Education: High school graduate required. Associates Degree or an equivalent combination or education and experience preferred.
Experience: At least one year within a healthcare provider and/or payer environment performing patient access and/or customer service activities, is desired.
Other Job Requirements:
Interpersonal skills necessary to negotiate in high-stress situations when representing the organization.
Excellent communication skills (verbal and written) and organizational abilities
Accuracy, attentiveness to detail and time management skills are required.
Working knowledge of third party payer regulations, requirements, and laws governing.
Working knowledge of medical terminology preferred.
Knowledge in word processing and spreadsheet applications required.
Ability to calculate figures and amounts such as discounts, co-insurance, co-pays and deductibles.
Must be able to set and organize own work priorities and adapt to them as they frequently change. Must be able to work concurrently on a variety of tasks in an environment that may be stressful. Excellent problem solving skills are essential.
Must be comfortable operating in a collaborative, shared leadership environment.
Must possess a personal presence that is characterized by a sense of honesty, integrity, and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goal and values of the organization.
Assigned hours within your shift, starting time, or days of work are subject to change based on departmental and/or organizational needs.
Our Commitment to Diversity and Inclusion
Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.
Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity.
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