Patient Account Representative - Point of Entry

PRIMARY PURPOSE/FUNCTION:

Responsible for pre-registering all patients appropriately.

PRIMARY RESPONSIBILITIES:

• Pre-registers patients based on specific services by entering demographic information and ordering test/procedure prior to the patient service date
• Obtain patient information by the patient's previous visit, contacting the patient by phone or information provided by physician offices.
• Obtains and enters pre-certifications and authorizations from physician offices.
• Utilizes the eligibility software to verify the patients have the insurance coverage as provided.
• Contacts physician offices for necessary information needed for insurance authorization.
• Calculates Co-pays and deductibles based on the patient's benefits and the Managed Care contracts, and government payer contracts.
• Responsible for contacting the patients by phone and explaining to the patient their insurance benefits, deductibles, co-pays that will be due prior to service, clinical instructions provided by the service department and other information such as valet parking, location of the test/procedure, and time of the test/procedure.
• Orders tests via the Health Information system.
• Utilizes the registration accuracy software to identify registration errors, and correct the accounts prior to billing.
• Reschedules patients as requested by the department or patient.
• Assist departments with transfers or bed placement (4900 number)
• Completes a pre-registration "to do" form that is sent with the paperwork daily to the registration staff.
• Held accountable for accuracy and timeliness of work.
• Participates in DIG, LEAN, and Six Sigma teams as requested.
• Provides other clerical duties as assigned.

QUALIFICATIONS:

Educational and/or Professional Qualifications:

1. High school diploma or GED preferred.
2. Ability to type on a keyboard with speed and accuracy.

Previous Experience:

1. Previous medical insurance experience such as billing, collecting, verifying, and pre-registering of patients.