Patient Account Representative - Point of Entry

PRIMARY PURPOSE/FUNCTION

Responsible for pre-registering all patients appropriately.

PRIMARY RESPONSIBILITIES

Pre-registers patients based on specific services by entering demographic information and ordering test/procedure prior to the patient service date Obtain patient information by the patient's previous visit, contacting the patient by phone or information provided by physician offices. Obtains and enters pre-certifications and authorizations from physician offices. Utilizes the eligibility software to verify the patients have the insurance coverage as provided. Contacts physician offices for necessary information needed for insurance authorization. Calculates Co-pays and deductibles based on the patient's benefits and the Managed Care contracts, and government payer contracts. Responsible for contacting the patients by phone and explaining to the patient their insurance benefits, deductibles, co-pays that will be due prior to service, clinical instructions provided by the service department and other information such as valet parking, location of the test/procedure, and time of the test/procedure. Orders tests via the Health Information system. Utilizes the registration accuracy software to identify registration errors, and correct the accounts prior to billing. Reschedules patients as requested by the department or patient. Assist departments with transfers or bed placement (4900 number) Completes a pre-registration "to do" form that is sent with the paperwork daily to the registration staff. Held accountable for accuracy and timeliness of work. Participates in DIG, LEAN, and Six Sigma teams as requested. Provides other clerical duties as assigned.

QUALIFICATIONS

Educational and/or

Professional Qualifications:

High school diploma or GED preferred. Ability to type on a keyboard with speed and accuracy.

Previous Experience:

1. Previous medical insurance experience such as billing, collecting, verifying, and pre-registering of patients.