Description
General Summary of Position
Responsible for inpatient and outpatient registration activities, which include assessing the patient's financial status, identifying and obtaining a source of payment and gathering sufficient information to facilitate reimbursement, ensuring the notification is accurate and complete, and interfacing with insurers and members of the health care team. Requires proficient and professional encounters with other departments, insurance companies, third-party administrators, physician offices, and associates to input correct patient demographics and insurance information, verify eligibility, and identify and obtain referral and authorization needs to ensure a seamless revenue cycle process.
Location: MedStar Georgetown University Hospital
Status: Full-time, 40 hours per week
Schedule: Sunday-Thursday, 6:30am-3pm
Primary Duties and Responsibilities
Initiates and receives phone calls from patients (some transferred from clinical Departments) aimed at accurately completing insurance FSC/Plan information at the patient registration and visit levels of the billing system, including Alternate Insurance information on the Appointment Data Form if appropriate. Must have knowledge of MGUH insurance contracts and the associated rules for claim submission in order to perform successfully, which is defined as meeting or exceeding the published productivity standards regarding calls taken and/or placed, system edits resolved, and other quantifiable variables required.Tracks and maintains referral and preauthorization records for all patients and ensures that authorizations are obtained, updated, and recorded in a timely manner, such that patient care is not inappropriately delayed and that denials are minimized.Provides complete pre-authorization, insurance verification, and basic benefits information on all outpatient registration accounts for patients utilizing the Medical Center's clinical systems. Performs duties pertaining to registration to include the use of GE Centricity Business/IDX and its supporting eligibility software programs to ensure accurate registration and capture of authorization/referral information for both IDX and SMS Invision. Updates patient demographic and insurance information; Maintains Department standards in terms of accounts accessed & accuracy rates.Ensures the presence of pre-authorization and/or insurance referral numbers prior to a patient receiving services at GUH based on various insurance requirements & rules. Also assists with the tracking of continuing or multi-use authorizations and referrals, while staying in contact with appropriate clinical department staff members if difficulties arise.Provides benefit coordination for patients in order to properly instruct when services will or will not be covered by insurance and whether any co-payments or deductibles will be due at the point of service. Refers some cases to the proper department for Financial Assistance assessment prior to treatment.Corrects accounts that have erroneous registration information and ensures that all associated claims have the correct financial classification so that timely and accurate claim submission occurs, thus facilitating successful revenue cycle processes.Communicates effectively and maintains positive relationships with external audiences, this includes but is not limited to communicating directly with patients for clarification and follow-up purposes.Acts timely on system edits to ensure that proper actions are taken on accounts so that successful reimbursement for services will occur (IDX Alerts and SMS, for example)CUSTOM.PRIMARY.DUTIES.RESPONSIBILITIES.ADDENDUM
Minimum Qualifications
Education
- High School Diploma or GED required.
- Associate degree preferred.
- "CONSIDERATION WILL BE GIVEN TO AN APPROPRIATE COMBINATION OF EDUCATION/TRAINING AND EXPERIENCE"
Experience
- Experience in a customer service-oriented environment required.
- Experience in hospital or physician registration, insurance verification and/or medical billing required.
Licenses and Certifications
Knowledge, Skills, and Abilities
- Excellent oral and written communication skills, excellent customer service skills, Detail oriented. Excellent organizational skills.
- Proficiency with medical terminology, experience with basic anatomy/physiology.
- Understanding of medical terminology, ICD-9 codes, and third-party payer procedures.
- Knowledge of computerized registration, scheduling, and billing systems is a plus.
- Good interpersonal and communication skills.
This position has a hiring range of $18.33 - $31.61
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