This position performs Patient Registration functions and the related Pre-AR and AR (AR = Accounts Receivable) activities.
The position is responsible for performing patient registration or updates to patient registration in order to assure that patient demographic and insurance coverage information is accurate to facilitate billing to patient, insurance coverage and/or other third party entities; references third party insurance information to validate and update insurance coverage.
Resolves system edits related to registration/insurance coverage to facilitate charge posting and related billing activities that facilitate accurate payment from third party payers or patients.
Assumes responsibility as a proactive resource and subject matter expert for registration and insurance coverage activities.Â
Completes or updates patient registration and insurance entry/verification using Epic system.Â Uses third party system data to validate insurance coverage and to accurately assign insurance coverage for the patient in the Epic system.Â Accurately determines the correct plan code to select for assignment of insurance coverage.
Works system edits related to patient demographic and insurance coverage so that claims or statements are accurately sent to insurance companies/other third party payers or patients.
Works claim denials related to registration and insurance coverage to resolve the issue and submit a corrected claim to the payer for adjudication and payment.
Troubleshoots complex issues related to registration/insurance coverage and accurately resolves the problem so that claims can be properly adjudicated and paid (goal is payment on first submission).
Identifies and documents issues, along with underlying root cause analysis, and assists with solutions that provide resolution or enhances business workflows.
Provides training to other Users for workflows related to registration and insurance coverage.
Demonstrated ability to interact and communicate with clarity, tact, and courtesy with co-workers, patrons, patients, staff faculty, students, and others.
Demonstrated ability to participate as a member of the Team in identifying priorities for the work unit and participate as a member of a work group or team.
Demonstrated ability to work with supervisor to identify and describe work task priorities.Â
Demonstrated critical thinking skills to be able to analyze a problem/issue and identify the correct actions that are needed to most effectively resolve the situation.
Demonstrated ability to communicate effectively in English, both orally and in writing.
Demonstrated ability to recognize and resolve or refer problems and conflicts.Â Must be able to remain calm and professional when dealing with an upset provider or other customer.
Demonstrated ability to negotiate and manage interpersonal communication effectively.
Confidentiality/discretion must be maintained at all times as will be handling confidential and sensitive information.
Ability to handle multiple concurrent tasks in a competent and professional manner in a fast paced atmosphere.
Ability to work with minimal supervision is required.
Ability to work for long periods of time in a sitting position, or at a keyboard.
Ability to bend/kneel to access files in filing cabinets or storage boxes.Â
Ability to drive or commute to various sites for occasional meeting.
Ability to work flexible hours on occasion.
Education, Experience, or Certifications
High School or equivalent required
College degree (2 yr or 4yr) preferred.
Minimum three years previous physician revenue cycleÂ experience.
Previous experience with physician revenue cycle and payers is required.
Previous experience with patient registration and insurance coverages.
Previous experience using physician billing/revenue cycle software and electronic medical records systemsÂ required; prior experience with Epic electronic medical record (EMR) software.
Previous experience and working knowledgeÂ regarding Â third party payer rules, procedures and policies in physician billing.
Technical Knowledge or Skills:
Demonstrated ability to use or learn to use a range of position related software applications.Â These may include standard software packages as well as networked systems, email, the Web, and other types of information structures.
Demonstrated ability to read and understand basic documentation such as Help screens and departmental handouts.
PC experience and MS Office (Word and Excel).
Pay Range: $20.61- $30.17
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Internal Number: JR11010
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