Job Details

Description

At The CORE Institute, we are dedicated to taking care of you so you can take care of business! Our robust benefits package includes the following:

• Competitive Health & Welfare Benefits
• Monthly $43 stipend to use toward ancillary benefits
• HSA with qualifying HDHP plans with company match
• 401k plan after 6 months of service with company match (Part-time employees included)
• Employee Assistance Program that is available 24/7 to provide support
• Employee Appreciation Days
• Employee Wellness Events

 Qualifications

• High school diploma/GED or equivalent is required.
• Familiar with and understand Medicare, Medicaid and other government payors and HMO/PPO payors guidelines and principals.
• Understands benefits (ie: deductibles, copays, and coinsurance) and how to calculate estimates per the payor contract as applicable.
• Previous patient registration in a medical office, hospital or outpatient surgery center.

Essential Functions

• Verify patient demographic, insurance, and financial information upon receipt of surgery booking sheet from scheduler.
• Verify patient type, procedure, and other case details in order to accurately obtain authorization, calculate patient responsibility and pre-register patient.
• Confirms primary and secondary insurance order based on COB rules. Direct patient to complete accident questionnaire and/or COB form.
• Collect State reporting and Meaningful Use data and input into PAS.
• Accurately document in and out of network benefits, all pertinent information regarding benefits and patient responsibility to include down payments and payment arrangements, authorization information and contact information to update insurer.
• Be familiar with individual payor guidelines and the process of collecting over the counter payments/deductibles/co-pay/coinsurance. Knowledge of payor contracts including Medicare, Medicaid and other government contracts and guidelines.
• Investigate questionable information promptly; i.e. MVA and work comp information that conflicts with insurer information.
• Notify Business Office Manager and Physician Office Liaison of any benefit, financial or authorization concerns or issues immediately.
• Check insurance company approved procedure lists/medical policies. If procedure is not payable, notify scheduling office.  If patient wants to proceed, obtain signature on Medicare ABN or other non-covered notification waiver form.
• Work two weeks ahead of surgeries in order to avoid late notice cancellations.
• Contact patients with financial responsibility information and works out payment arrangements prior to patient arrival.
• Notifies Revenue Cycle Manager immediately when the patient’s insurance is out of network. Follow hospital guidelines when accepting out of network payors
• Notifies lead coordinator of cash pay patients. Obtains cash price from lead. Informs patients of cash price according to hospital policy.
• Review entered information with patient to ensure accuracy.
• Scan photo id and insurance card(s) into EMR. Make any corrections to insurance information upon review of insurance card(s) when necessary.
• Request Living Will/Advance Directives. Provide information if requested on where to obtain information on said forms to patient.  Document when patient requests information and that it was provided in order to meet state and Joint Commission requirements.
• Complete Medicare MSP questionnaire when necessary.
• Collect patient responsibility upon admission.
• Obtain patient signature on required forms.
• Print labels and wristband. Place wristband on patient.  Take chart with labels to Pre-op and notify nurses that patient is registered.
• Maintain AR days over 90 < 15%
• Maintain AR days (unpaid claims) at 45 days or less.
• Meet or exceed monthly, quarterly and yearly cash collection goals.
• Discusses patient information with other health team members in an appropriate environment.
• Interacts with all patients, families, visitors and fellow teammates in a mature, responsible manner to ensure a positive and professional facility environment.
• Must have a clear understanding of KPI and Metric’s measures and ability to complete daily tasks in order to meet Departmental and Hospital measures.

Behaviors

Motivations

Education

Experience

Licenses & Certifications