General Summary of Position Responsibility:
Initiates the pre-admission process for patients with advanced notice of upcoming admission to the hospital. Obtains demographic and financial information to complete the admission process. Ensures that required consents are obtained. Assists with the registration for pre-surgical testing. Serves as a resource for families regarding available hospital services. Provides patients and family members with information regarding financial matters. Ensures that patient financial services are coordinated for all services. Documents that there are adequate third-party/self-pay resources available to pay for services provided and/or recommend alternatives when there are insufficient financial resources.
Essential Job Functions:
Pre-admits patients in Epic via the Epic Work queue during the interviewing of parents either by telephone or in person.
Identifies potential duplicate medical record numbers and notifies appropriate parties.
Performs registration functions for all pre-surgical testing patients, inpatients, observation, emergency department patients, outpatient surgery patients and some ambulatory or ancillary patients. Completes all transfers from the Emergency Department.
Accepts, documents, and files all admission reservations received from physicians or from office staff. Maintains accurate statistics and records. Determines and verifies legal guardianship when required, and obtains consent for admission and medical treatment.
Coordinates the day’s admissions and bed activity with the Patient Access Center.
Maintains communication with nursing, physicians, ancillary departments, patient relations, business services and other hospital services to ensure the facilitation of the admission process.
Verifies insurance benefits. Initiates pre-certification requirements and coordinates with parents to insure managed care authorizations are obtained. Works with division offices to ensure completion of requirements prior to the date of admission.
Reviews all inpatient accounts on a weekly basis, identifying those accounts which have been in house for 30 days or more. Re-verifies insurance benefits for all long stay accounts. Updates Epic insurance screens as required. Accounts are followed up appropriately and timely.
Reviews insurance benefits with parents to determine their ability to pay. Review, calculate, collect and post all co-pays, deductibles, self-pay, bad debt or any other out of pocket expense. Balance cash drawer at the end of the business day.
Identifies admissions that may be eligible for State agency funding or with the Lurie Children’s Financial Assistance Program. Completes referrals to the Medicaid Liaison. Complete DSCC or IDPH applications. Make appropriate referrals to Social Security.
Reviews all patient class changes on a daily basis to identify potential problem accounts.
Performs job functions adhering to service principles with customer service focus of innovation, service excellence and teamwork to provide the highest quality care and service to our patients, families, co-workers and others.
Knowledge, Skills and Abilities:
High school diploma required; Two years of college preferred (business or healthcare course work).
CHAA Certified (Certified Healthcare Access Associate) preferred.
Minimum two years of business office experience in hospital or physician office setting.
Extensive knowledge of patient registration functions, insurance benefit verification, and financial counseling.
Knowledge of medical terminology, managed care requirements, and government agency regulations.
Ability to communicate effectively with patients and third party payers is essential.
Bilingual language skills helpful.
Substantial interpersonal skills required to work effectively in stress situations with pediatric patients, families, physicians, nurses, and other allied health-care personnel.
Reasonable likelihood of some occupational exposure to pathogens during the performance of assigned duties.