A Registration Coordinator in a Clinical Setting communicates with patients, families, physicians, quality review, clinical staff and insurance companies to obtain information and insurance verification to assure quality patient care and payment of hospital accounts. Interviews and registers outpatients and inpatients. Responsible for the authorization and pre- certification of services by coordinating and performing activities required for verification and authorization of insurance benefits for services. Proactively identifies and communicates with families the financial resources available to patients, whose health plan does not include coverage for services, coordinating counseling services with Social Work as required. Collaborates with Appeals department to overturn claims denial. Provides other registration, clerical and billing support as required such as scheduling, chart creation, charge entry, etc.
ESSENTIAL JOB DUTIES AND RESPONSIBILITIES
At time of visit or via telephone, interviews patients, families, or outside to obtain complete and accurate demographic and financial information. Ensures that all necessary questionnaires and forms are completed according to pre-determined requirements by government or regulatory agencies. Confirms insurance coverage and obtains authorizations if applicable. Explains regulatory financial requirements to the patient or responsible party and collects and posts deposits or deductible amounts as required.
Enters data into system for registration, billing, and patient tracking. Handles this data entry in a fast, efficient way to decrease wait time for customer.
Coordinates and performs verification of insurance benefits by contacting insurance provider and determining eligibility of coverage, and communicates the status of verification/authorization process with appropriate team members in a timely and efficient manner. Provides clinical information as needed, emphasizing the medical justification for procedure/service to insurance companies for completion of pre-certification process.
Ensures referring physician obtains prior authorization as needed, from insurance company for all scheduled healthcare procedures within assigned department/area.
Contacts referring physicians and or/patients to discuss rescheduling of procedures due to incomplete/partial authorizations, obtains Letter of Medical Necessity and scripts as needed. Reschedules procedures in consideration of appointments cancelled due to insurance authorization issues and utilizes cancellation waitlist to optimize departmental efficiencies.
Maintains tracking of patients on schedule, ensuring that eligibility and authorization information has been entered into data entry systems.
Pre-screens doctor's orders (scripts) received for new patient to ensure completeness/appropriateness of scheduled appointment.
Collaborates with Appeals department to provide all related information to overturn claims denial.
Monitors insurance authorization issues to identify trends and participates in process improvement initiatives
Acts as liaison between patients and department staff by informing patients and families of procedures and delays, answering questions, offering assistance, relaying messages, and other services that the patients and families may require. Ensures wait time communication occurs by updating schedulers and patient information tools as appropriate.
Participates in charge/ payment reconciliation and/or charge posting activities as needed. Ensures all charge tickets/super-bills contains correct information (re: financial/demographic and CPT codes).
Initiates and executes daily medical record maintenance while maintaining patient confidentiality to include creation of patient charts, filing encounter specific paperwork, maintaining correspondence via mailing/faxing with patient's primary care provider and/or specialists as necessary. Provides release of medical information as required.
May initiate and perform multi-tasked administrative duties to ensure efficient daily business operations including participating in the office/department opening and closing procedures, assisting with maintaining, ordering, and restocking of front office supplies, and receiving and distributing mail.
Participates in meetings and may serve on committees representing the department which could include multi-disciplinary quality and service improvement teams.
May have additional department specific duties as necessary.
High school graduation or equivalent. College degree preferred.
Six (6) months at Children's Healthcare of Atlanta as an
with demonstrated excellence or two (2) years medical facility experience required. Pediatric medical facility experience a plus
CPAR certification preferred.
Understand and be familiar with medical terminology
Must be able to type 45 words per minute
Must score at least 85% on an alpha and numeric data entry proficiency test
Must score at least 85% on an arithmetic and word mathematical problem solving skills (I also think this needs to be 85% or greater)
Basic Windows XP and Microsoft Word XP required. Must pass Windows Basic Skills Competency test with at least 80%.
Knowledge and utilization of patient registration systems, insurance verification systems, and/or Medicaid portals is highly desired
Strong verbal / written communication skills required.
Proven ability to multi-task.
Must have a flexible schedule in order to work different shifts as needed.
Ability to travel within metro Atlanta as needed to support multiple locations or different departments.
Children's at Hudson Bridge
Hours Per Week
Children's Healthcare of Atlanta is a not-for-profit hospital system that specializes in pediatric health care, research, and...