Admitting Representative-Outpatient Registration Job in Portland, Maine US
Admitting Representative-Outpatient Registration
Summary of Position Description Pre-admits and admits scheduled and some emergency admissions to the hospital. Serves as the important first contact for many MMC patients. May be called upon to provide all customer service functions and must convey a caring and professional attitude for sick patients. Determines insurance coverage, eligibility, and performs required pre-authorization procedures. Maintains bed control for all inpatient units. Provides comprehensive financial counseling and assistance. Establishes and monitors each patient's account prior to their admission, during their inpatient stay, and up to 3 days after discharge. Ensures the accuracy of the patient's unique identification number and the demographic and financial information used to create an electronic bill. Registers other types of patients such as recurring patients, Observation, Short Stay and Outpatients. Minimum Knowledge, Skills, and Abilities Required This position requires: 1) The employee to have experience with or the capability to be trained to a high degree of skill in analytical and complex problem solving 2) The ability to handle complex financial and insurance detail, and 3) The discipline to follow through with persistent thoroughness to the accurate resolution of each case presented to them. The representative needs: 1) A general knowledge of state and federal agencies, regulations 2) Understanding of medical terminology 3) Understanding of basic customer relations principles 4) The ability to deal with complex billing systems. These skills need to be at a level that would be acquired through one to two years of prior related experience and 6 months of intensive on the job training in billing and collections; hospital polices and computer systems, the functions of registration, and the detailed functions of Central Registry. The work requires verbal and written communication skills, and the ability to accomplish duties in an accurate and efficient manner. The ability to determine which one of possibly 500 constantly changing insurance products, each with potentially multiple and differing contracts applies to the patient being registered. An ability to determine and implement the specific related pre-authorization requirements necessary to prevent later denial of charges by the carrier. Ability to perform multiple tasks simultaneously while maintaining accuracy. An ability to deal effectively with verbally offensive and or distressed patients and their families. Ability to understand, interpret and explain departmental and institutional policies and procedures. Outstanding organization skills including knowledge of quality improvement tools and techniques. An ability to work somewhat independently (without direct supervision) because of multi-site settings. An ability to work in an extremely fast paced office with constant interruptions, activity and stress due to high volumes and time constraints, and interactions with sick patients, while maintaining a compassionate attitude. Must have strong customer service skills with the sensitivity and intuition to detect hidden stresses or problems and with the ability to be resourceful and creative in their resolution. Must maintain a high energy and positive outlook, as well as a calm and impartial response in dealing with a wide variety of complaints, personalities, levels of stress, complicated situations, illness, and urgent demands. Computer experience is required with Microsoft Word, e-mail and internet communications, as well as the ability to work effectively with electronic work quality monitoring, and electronic scheduling systems. Must be able to function effectively as a member of a highly integrated team of coworkers with mutual interdependencies as well as to contribute effectively as a member of specific project teams. High school diploma is a minimum requirement. Two to 5 years of related prior experience in the medical or insurance fields. Must have the interpersonal skills to deal effectively, cordially and compassionately with a diverse group of physicians, other staff personnel as well as outside hospitals, agencies and the general public. These skills must include the capacity to be sensitive to the individual problems of each patient in obtaining patient information, solving complex patient placement and payment problems. Mathematical skills sufficient to calculate financial formulas to support applications for Free Care eligibility.