Professional Billing Registration - Patient Access Associate II - Per Diem

Overview

Under general supervision, coordinates and performs multiple complex functions within the Patient Access department. Utilizes judgment to interpret department policies to resolve routine to complex inquiries/patient account problems with other departments. Identifies opportunities for process improvements and offers potential solutions. Participates in meetings as a representative of the department. Serves as a resource to team members for training, problem resolution, etc.

Performs all duties in a manner that promotes a team concept and reflects the mission, behaviors, core values and philosophy of CT Children’s Medical Center.

Administrative:

• Following department protocol provides general receptionist, secretarial support, or Health Unit Coordinator functions.
• Performs a variety of administrative support activities in support of the unit operations.
• Responds with tact and discretion to the needs of patients and families.
• Maintains privacy and confidentiality.
• Assists with staffing assignments and scheduling as requested.

Registration:

• Collects and enters accurate demographic, guarantor and financial data for Emergency Department, Inpatient and Outpatient cases and Physician Practice Office appointments.
• Verifies all required insurance and billing information and uses the proper payer plan codes.
• Generates all necessary forms for patient visit and obtains patient/parent/legal guardian signature for Assignment/ Authorization and consent.
• Performs pre-registration for scheduled patients and registers patients upon arrival adhering to standard department procedure.
• Makes corrections and updates patient information in computer systems as necessary.
• 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. Documents concise and understandable comments regarding patient or guarantor interaction, efforts to collect co-payments and referrals to Financial Assistance.
• Follows-up on open items to resolve outstanding issues and complete the file.
• Reviews all documentation records regarding incomplete information at time of registration, patient or guarantor interaction, efforts to collect co-payments, estimated self-pay balances and referrals to Financial Assistance.
• Follows up with team member responsible for resolving the open issue to provide assistance or additional training to ensure prompt completion of the file.
• Reviews and works assigned work queues for registration information to ensure that accounts are accurate at time of visit and or billing.

Scheduling:

• Schedule complex appointments either in person or via telephone
• Creates/inputs complex department provider appointments.
• May schedule/coordinate appointments with other areas of the hospital.
• As a first line representative of CT Children’s, this person must have the ability to deal compassionately and professionally with patients and families.

Front Office (Check-In)

• Arrives patients for their appointment in the ADT system.
• Verifies demographic and insurance information at time of arrival (including securing patient financial liability at time of service).
• Check out process including scheduling or rescheduling future appointments.
• Answer telephone and triage calls for the department.
• Ensure all consent and privacy forms are signed.
• Work directly with DCF to obtain appropriate signatures/legal guardian information.
• Enters routine to complex patient charges into billing system for physician or care provider visits, according to protocol.
• Other front office duties as required.

Financial Clearance:

• Responsible for various work queues of scheduled and/or non-scheduled appointments.
• Communicates with insurance companies to obtain benefits, referrals, and/or authorization requirements.
• Communicates with Clinical/Office staff of patient eligibility, authorization status, and need for clinical documentation.
• Completes chart reviews to submit all appropriate documentation to insurance companies for authorization purposes.
• Coordinates with third party payers regarding…