Registration & Eligibility Specialist

Minimum Offer

$ 16.59/hr.

Maximum Offer

$ 22.95/hr.

Compensation Disclaimer

Compensation for this role is based on a number of factors, including but not limited to experience, education, and other business and organizational considerations.

Minimum

Offer:

$16.59/hr.

Maximum

Offer:

$22.95/hr.

Compensation Disclaimer:
Compensation for this role is based on a number of factors, including but not limited to experience, education, and other business and organizational considerations.

Department:
Case Management - SRMC

FTE: 1.00

Full Time

Shift: Days

Position Summary: Perform pre-registration and registration functions for area assigned; verify insurance coverage eligibility and benefits; obtain authorization for admission; verify required referrals and/or prior authorization are in place; interview patients for outdated or missing demographics; professional and efficient phone call handling via telephone ACD system in a call center setting; perform as first contact for Persons in Custody of Law Enforcement Agency (PICLEA) as they arrive for care;

screen patients for coverage and assist them in navigating their financial options including UNMH or other UNM Health Systems financial assistance, NM Medicaid, or other State and Federal Programs. Advise, inform and assist patients before and after their admission. Ensure adherence to Hospitals and departmental policies and procedures. No patient care assignment.

• FINANCIAL ASSISTANCE - Interview patients and complete the application process for State/Government programs; maintain MOSAA certification with the State; interview and approve patients for UNM Hospital charity and discount programs
• CASH - Reconcile and complete cash reconciliation reports; balance and post payments, contractual allowances, and denials
• TRAINING - Perform training with registration and admitting personnel to assure proper registration and knowledge of business practices to include financial assistance programs
• DEVELOPMENT - Enhance professional growth and development through participation in educational programs, reading current literature, attending in-services, meetings and workshops
• PATIENT CARE - Assist patients in locating departments; schedule and coordinate patient appointments; refer patients and families to appropriate services and resources
• RELATED WORK - Perform related duties and responsibilities as required
• INFORMATION - Interview patients and/or family at time of admission, pre-admission or discharge to obtain accurate demographic, and financial information; update information on Hospitals computer system to ensure correct billing; register patients for the Laboratory and clinics after hours; provide billing information to Ambulance Services
• SIGNATURE - Obtain proper signatures for Medicare Rights Consent for Treatment, financial forms for applying for assistance, and other forms as appropriate; assure that patient rights are distributed
• PRIOR AUTH/INSURANCE - Verify insurance coverage and benefits on patients needing an Auth; provide notification of admission and obtain auth for emergency admits; obtain authorizations for same day surgery, inpatient surgery, direct admits and any other pre scheduled stays or procedures. Provide all pertinent medical history/documentation for insurance companies and other payors in order to obtian an auth; document Cerner with correct information;
  Scan all documents concerning authorization and reimbursement into Siemens document imaging; may collect down payments for and copays for procedures. Create Pre Admits in Cerner as appropriate
• ELIGIBILITY - Determine and process eligibility for financial assistance (Including Medicaid, SCI, UNM Care, Commercial, Medicare, PHS/Indian Health Service, Salud, Self Pay)
• FRONT DESK - Answer phones at front desk and assist walk-in patients as needed. Provide after hours/weekend information desk coverage for the hospital. Re-identify patients for Blood Bank and Health Information Management Department. Organize folders for floor visits to patients. Admit surgical patients and direct admits that present to the Admitting office. Input all pre-admits for PALS and direct admissions as appropriate.
  
  Log all admissions in the Admitting logs.
• REFERRALS - Maintain a knowledge of community financial resources and refer patients appropriately (EMSA).
• PATIENT CARE - Accept and issue patient s valuables from patients and the Emergency Department Staff. Perform floor visits to interview patients after a direct admit from the Emergency Department or the clinics
• DOCUMENTATION
  - Send all pertinent medical documentation to insurance companies and other payors for approval. Document final authorization in Cerner and scan all paperwork into Siemens scanning
• CUSTOMER SERVICE - Provide information and assistance to internal and external customers; provide and ensure quality service and customer satisfaction
• REGISTRATION - Interview patients and/or families to obtain demographic, financial information and signatures as…