Job Description

Patient Registration Representative I

Shifts per week/schedule: Admitting - 5x8 11-19:30 Must have full day availability for first 2 weeks. All candidates will be informed of the required flexibility for initial training, including morning availability for computer and department onboarding. We do not have set schedules as staff is scheduled based on department needs. Although we try to be consistent, the days they work might vary from one week to the next because of vacation requests, coverage, etc.

POSITION SUMMARY:

Performs all tasks related to pre-registration, and registering of inpatients and outpatients including securing and calculating upfront collections with co-pays, and co-insurance in an efficient, accurate and hospitable manner to ensure that patient, physician and hospital needs are met. Completes the Hospital Presumptive Eligibility comprehensive training program as required to properly interview and screen uninsured patients. Evaluates patients within the established guidelines to assist in identifying state programs that patients may qualify and link to temporary M/Cal coverage and possible full scope M/Cal. Initiate and completes the application process for benefits by assisting applicants with the completion of all the necessary paperwork. Compiles records and assess information to determine eligibility status, including number of people in applicant's household. Documents and update efforts in our database to ensure we have current updates on the outcome and successful completion of process. For Emergency Registration Representatives they will continue to enhance their registration knowledge along with the fundamental financial counseling skills required and expected of the financial counselor role, which is inclusive of the diverse financial programs offered at PIH Health.

SPECIFIC SKILLS NEEDED:

Must have excellent written and verbal communication skills to communicate effectively with staff, patients, guarantors, insurance companies, and physicians. Demonstrated attention to detail; Good English speaking, spelling, reading and Mathematical skills required Demonstrate ability to learn quickly, and follow directions as outlined in policies or given by Supervisor Strong Computer skills and Knowledge in Word, Excel and ability to maneuvering through multiple screens in a timely manner 1+ year of medical office /hospital work experience preferred Medical terminology knowledge strongly preferred Insurance knowledge required Ability to multi- task in a fast and high pressured environment Stringent adherence to all HIPPA laws Strong typing skills 45 and up wpm is required Strong analytical skills, problem solving. The ability to act and decide accordingly. Complete HPE comprehensive training program as required Excellent Customer service and phone skills with a background in the medical industry Ability to travel to off-site locations (Outpatient only)

EDUCATION/EXPERIENCE/TRAINING:

One year experience in a high volume healthcare facility or medical office setting with strong computer and customer service experience required High school graduate required or equivalent, evidence of continuing education preferred. Medical terminology strongly preferred Insurance and billing experience strongly required Drivers License; ability to travel to off-site locations (Outpatient /Financial counseling only) Bilingual Spanish or Chinese (Mandarin) preferred HPE comprehensive training program and certification

DUTIES AND RESPONSIBILITIES:

1. Safeguards and preserves the confidentiality of patient's protected health information in accordance with State and Federal (HIPAA) regulatory requirements, hospital and departmental policies. 2. Ensures a safe patient environment and adherence to safety practices per policy. 3. With consideration to age, employee utilizes the approved process to resolve biophysical, psychological, educational and environmental needs of patient/significant other when administering care. 4. Guest Relations: Exhibits positive guest relations skills by extending oneself and being hospitable to patients, physicians, coworkers, and visitors at all times. Warmly greets these by name and introduces self by name. Uses the phrase, "How can I help you?" as a first line of communication. Anticipates concerns and provides an explanation of the interview process. Full disclosure is provided to patient when starting the interview and screening process for Hospital Presumptive Eligibility and/or Uncompensated application so they understand the process. Utilizes translators if available or new translating system Stratus as necessary to ensure patient fully understands the information being discussed with them. Displays a teamwork approach, considering the impact of his/her decisions, actions and behaviors on others. Works with the agency workers and representatives to create a positive working relationship that will provide a smooth process for the patient. Responds to others in a constructive, non-defensive manner. Maintains a professional appearance at all times, wearing uniforms or adhering to department dress code requirement, as per policy 86500.718. Answers telephone by the third ring and states, "______ department, this is ______, and how can I help you?" Expresses ideas clearly, actively listens and always follows appropriate channels of communication. Maintains confidentiality at all times. 5. Organizational skills and Efficiency: Able to solve problems without compromising the patient's needs. Sets priorities, integrates changes and organizes work activities in a logical and timely manner. Initiate and complete the application process for HPE or Uncompensated benefits by assisting patients with the completion of all the necessary paperwork and works aggressively to obtain all the pending verifications information needed to processes application. Demonstrates a consistent level of performance and productivity. Files orders in the correct files and places files in the appropriate file (and scan into AM). Follows all procedures in department as instructed by management. Uses time wisely to pre-register all scheduled patients, as per policy (see 85600.227). Prepares necessary paperwork, orders, labels, and Optio forms for signature to expedite the registration process upon the patient's arrival. Makes good use of time, seeks out work that needs to be done (ex. pre's), reports free time to supervisor. Responsible for completing all assigned procedures during shift without sacrificing the quality of work. Limits personal phone calls to breaks and lunches: away from the work area. EMERGENCY: Productivity: completes a minimum of 15-20 registrations per 8 hr shift which includes scanning documents, insurance verification and securing upfront collections. Verifies patients are appropriately medically screened, stabilized and in a room "in the process of care" before Consent of Admissions is signed/discussed and or liability is requested. No patients are to leave the Emergency Department without registration being completed. Registration representative will start the interview and screening process for Hospital Presumptive Eligibility for patients without insurance who present in the Emergency department. Registration representative will evaluate patients within established guidelines to assist in identifying qualification to the HPE program. Registration representative will be required to following the M/Cal guidelines and regulatory requirements to secure the most accurate information needed to complete the application process. Registration representative will ensure all insurance, demographic and eligibility information is obtained and entered into the system accurately and notifies appropriate agency workers and hospital staff. Registration clerk will document and update efforts in our database to ensure our hospital and financial system contains the current and same information. If patient qualifies for HPE, after interview process, the registration representative will printout eligibility card and scan into Access Manager, adjust insurance payor to reflect this insurance coverage, then present it to the patient. All required documentation will be distributed to the patient informing them of the time requirements and follow up process to qualify for full scope M/Cal if applicable. Registration clerk will log HPE information on T drive graph for tracking purposes and place original forms in interdepartmental envelope and forward to Business Office. If patient does not qualify for HPE the clerk will pre-screen for hospital's Uncompensated Care program based on financial income and family size. If patient qualifies for this program, clerk will complete application process with patient, scan into Access Manager and submit original to the business office for approval process. Registration clerk will document into MS4 the entire process to notify the business office staff of outcome and status for this patient. Timeliness: registers all patients who present in a timely manner. Patients are to have the full registration completed with the COA signature obtained within 30minutes of arriving to a bed. Documents appropriately, "registration complete" in eMD. ADMITTING/OUTPATIENT DEPARTMENTS: Productivity: completes a minimum of 18-20 full registrations per 8hour shift or 30 pre-registrations per 8 hr shift. Completes full pre-registrations for scheduled patients within 2 business days of being scheduled or if patient presents in department to preregister. All scheduled patients are to have the full pre-registration process completed, which includes Patient Payment Estimator issued on all accounts along with securing copay/liability over the phone when applicable or no later than the day prior to procedures. Admitting: Responsible for identifying and capturing all Self Pay accounts from emergency department to start the interview and screening process for Hospital Presumptive Eligibility and/or uncompensated care proram. Timeliness: registers all patients who present in a timely manner. All patients are to be registered within 15 minutes of arriving for service. If there is a delay past that time frame, management is to be contacted for assistance. Front desk clerk/OB Admitting: Completes a minimum of 15-18 registrations/ pre-registrations per an 8hr shift, which includes scanning documents, verifying eligibility via Passport, front end collections with PPE application and accurate order entry. OB Admitting: Will schedule all OB procedures (C-Sections, Pre-op, Inductions, etc.,) in Enterprise scheduling system. 6. Flexibility: Demonstrates ability and willingness to work productively in all registration departments. Exercises independent and efficient judgment in times of need and emergency situations while adhering to departmental and hospital policies. Demonstrates willingness to adjust schedule

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