Under general supervision, coordinates and performs a variety of administrative, registration and financial support
duties for the unit/department. Utilizes judgment to interpret department policies to resolve routine inquiries/problems. Identifies opportunities for process improvements. Performs all duties in a manner that promotes a team concept and reflects the mission and philosophy of CCMC.
Following department protocol provides general receptionist and secretarial support. Reviews and works assigned workques for registration information to ensure that accounts are accurate at time of visit and or billing. Responds with tact and discretion to the needs of patients and families. Maintains privacy and confidentiality.
Collects and enters accurate demographic, guarantor and financial data for Emergency Department, Inpatient and Outpatient cases. Inputs all required insurance and billing information and uses the proper payer plan codes. Generates all necessary forms for patient visit and has patient/parent/legal guardian sign Assignment/Authorization and consent form. Performs pre-registration for scheduled patients and registers patients upon arrival adhering to standard admitting policies. Makes corrections and updates patient information in computer systems as necessary. Completes procedures for patient status/room transfers. Asks patients/families whether their visit was satisfactory and attempts to address any questions/issues prior to patient departure.
Documents thorough, clear, explanatory notes regarding reasons for incomplete information at time of registration and documents insurance verification method along with response. Documents concise and understandable comments regarding patient or guarantor interaction, efforts to collect co-payments and estimated self-pay balances and referrals to Medicaid. Follows-up on open items to resolve outstanding issues and complete the file.
Verifies insurance plans using the various methods available such as, web-based, HDX and telecommunications. Investigates patient insurance coverage, facilitates certification, manages process to maximize payment from both commercial and managed care plans. Coordinates with third party payers regarding information necessary for appropriate financial processing of patients, including: follow-ups with primary care providers for referrals and authorizations; notifying insurance carriers of admissions; obtaining authorizations and verifying benefits eligibility. Refers patients/ families to DSS and or Financial Counselor for assistance.
Attempts to collect the co-payment, estimated self-pay balance of all ED accounts at the designated collection point. Interviews patients to verify complete insurance and financial information, explain financial policies, complete appropriate financial evaluation forms. Identifies those patients without adequate insurance coverage.
Determines guarantor’s ability to pay non-covered charges, as well as determine potential eligibility for financial assistance programs.
Demonstrates knowledge of the age-related differences and needs of patients in appropriate, specific populations from neonate through adolescence and applies them to practice. Demonstrates cultural sensitivity in all interactions with patients/families.
Demonstrates support for the mission, core values and goals of the organization through behaviors that are consistent with the CCMC standards.
High school diploma or GED required
1 - 3 years directly related experience required, Healthcare experience preferred
- Working knowledge of MS Word and Excel
- ADT systems and Insurance Verification systems (SMS, EPIC, IBEX, SCM preferred)
- Knowledge of Managed Care, referral/pre-certification/ authorization process.
- Computer, typing, data entry
- Excellent telephone and communication skills
For HR Use Only:
- Handle a fast paced, high volume environment,
- Work in a team environment along side multiple disciplines
Connecticut Children's Medical Center - 2 years ago
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When their tiny tykes needs some TLC, Nutmeg Staters turn to Connecticut Children's Medical Center (CCMC). CCMC's centerpiece...