Patient Access Coordinator-Obstetrics HUC/Registration FT nights
The Christ Hospital Health Network, Cincinnati, OH, United States
Job Description
Obtain and verify appropriate personal, demographic and financial information for the purposes of ensuring (1) quality patient care through proper patient identification and (2) maximal reimbursement for all billable clinical services rendered. Scan the appropriate identification documents into OnBase, obtain EMTALA notification signature, notify clinical staff when patients present with a critical condition, and once verified place appropriate insurance information on account.
Responsibilities
Analyze patient accounts; evaluate financial data for establishment of current accounts and document actions taken to maximize reimbursement. Maintain knowledge of current HMO, PPO, Medicaid, Medicare, and commercial insurance regulations and requirements. Determine all insurance coverage as primary, secondary, tertiary, etc., and complete required MSPQ questionnaires for all appropriate patients. Obtain and document clinical referrals from other providers, coordinate patients in need of financial assistance to pay for present and/or future services to the appropriate Financial Counselor, and collect/deposit all required insurance co‑payments according to specified protocols.
Analytical Skills
Initiate online verification of third‑party insurance carriers and plan administrators to verify patient benefits. Evaluate and prepare chart documentation to establish that medical necessity guidelines have been met. Prepare and complete documentation that establishes Medicare compliance such as the Medicare Secondary Payor Questionnaire and Advance Beneficiary Notice. Document appropriate data in account documentation and guarantor notes.
Clinical Skill
Process emergency and obstetrics cases by notifying appropriate staff.
Compliance Skills
Obtain signatures for the visit for all revenue cycle documentation. Prepare charts, collected forms and photocopies (insurance cards) and documentation. Distribute, witness by signature, and collect patient advanced directive forms/information; refer patients to appropriate personnel to address specific questions as indicated. Provide patients with information about their rights and responsibilities and all other duties as assigned.
Communication/Interpretation Skill
Interview patients and obtain, verify and enter complete and accurate demographic and financial information. Assess and update information as it relates to each encounter, determine financial plan and coverage priority. Data collected directly impacts financial and clinical systems.
Maintain facility‑established productivity standards and patient accounts quality guidelines (i.e., 100% accuracy for 95% of all registrations). Communicate effectively and meet or exceed established customer service goals.
Education and Leadership Skills
Provide education and training/mentoring for other staff members. Attend department meetings and review procedural and process changes per facility‑specific guidelines.
Qualifications
Knowledge and Skills
High school diploma; associate’s degree preferred or equivalent combination of education and experience. One to three years of experience in registration, billing, customer service, or managed care organization work environment. Knowledge of hospital medical staff rules and infection control policies. Analytical skills required for decision making. Computer literacy using multiple systems, including Epic, Passport, OnBase, Microsoft Office products, and Midas. Ability to use internet access and utilize third party payor systems for eligibility and verification. Knowledge of health insurance coverage and requirements. Excellent communication, problem‑solving skills, and ability to deal with customers who are often adversarial. Flexibility, organization, and the ability to function well in stressful situations. Ability to interact independently to resolve customer service issues. Must understand medical terminology and acuity levels.
Licenses & Certifications
Annual registration competency review with a 95% or greater score obtained; yearly STAT testing completed.
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Obtain and verify appropriate personal, demographic and financial information for the purposes of ensuring (1) quality patient care through proper patient identification and (2) maximal reimbursement for all billable clinical services rendered. Scan the appropriate identification documents into OnBase, obtain EMTALA notification signature, notify clinical staff when patients present with a critical condition, and once verified place appropriate insurance information on account.
Responsibilities
Analyze patient accounts; evaluate financial data for establishment of current accounts and document actions taken to maximize reimbursement. Maintain knowledge of current HMO, PPO, Medicaid, Medicare, and commercial insurance regulations and requirements. Determine all insurance coverage as primary, secondary, tertiary, etc., and complete required MSPQ questionnaires for all appropriate patients. Obtain and document clinical referrals from other providers, coordinate patients in need of financial assistance to pay for present and/or future services to the appropriate Financial Counselor, and collect/deposit all required insurance co‑payments according to specified protocols.
Analytical Skills
Initiate online verification of third‑party insurance carriers and plan administrators to verify patient benefits. Evaluate and prepare chart documentation to establish that medical necessity guidelines have been met. Prepare and complete documentation that establishes Medicare compliance such as the Medicare Secondary Payor Questionnaire and Advance Beneficiary Notice. Document appropriate data in account documentation and guarantor notes.
Clinical Skill
Process emergency and obstetrics cases by notifying appropriate staff.
Compliance Skills
Obtain signatures for the visit for all revenue cycle documentation. Prepare charts, collected forms and photocopies (insurance cards) and documentation. Distribute, witness by signature, and collect patient advanced directive forms/information; refer patients to appropriate personnel to address specific questions as indicated. Provide patients with information about their rights and responsibilities and all other duties as assigned.
Communication/Interpretation Skill
Interview patients and obtain, verify and enter complete and accurate demographic and financial information. Assess and update information as it relates to each encounter, determine financial plan and coverage priority. Data collected directly impacts financial and clinical systems.
Maintain facility‑established productivity standards and patient accounts quality guidelines (i.e., 100% accuracy for 95% of all registrations). Communicate effectively and meet or exceed established customer service goals.
Education and Leadership Skills
Provide education and training/mentoring for other staff members. Attend department meetings and review procedural and process changes per facility‑specific guidelines.
Qualifications
Knowledge and Skills
High school diploma; associate’s degree preferred or equivalent combination of education and experience. One to three years of experience in registration, billing, customer service, or managed care organization work environment. Knowledge of hospital medical staff rules and infection control policies. Analytical skills required for decision making. Computer literacy using multiple systems, including Epic, Passport, OnBase, Microsoft Office products, and Midas. Ability to use internet access and utilize third party payor systems for eligibility and verification. Knowledge of health insurance coverage and requirements. Excellent communication, problem‑solving skills, and ability to deal with customers who are often adversarial. Flexibility, organization, and the ability to function well in stressful situations. Ability to interact independently to resolve customer service issues. Must understand medical terminology and acuity levels.
Licenses & Certifications
Annual registration competency review with a 95% or greater score obtained; yearly STAT testing completed.
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