Reg/sched rep | call center (full time)

REGISTRATION/SCHEDULING:

• Receives and interviews patient or responsible individual to gather, verify and enter demographic and insurance information necessary for completion of electronic health record and insurance claim processing at each patient visit in electronic health record.
• Schedules, preregisters, cancels, reschedules tests and procedures for clinics and hospital and coordinates scheduling of tests and procedures to assure they meet medical necessity, patient, department and practitioner needs while maintaining appointment schedule according to department procedure.
• Ensure the patient or guardian understands and signs consent, insurance and other required forms.
• Receives, transcribes, schedules and scans practitioner orders into electronic record daily.
• Enters reason for tests/procedure to meet medical necessity and refers to UR for further review if needed. Refers tests/procedures to UR that need prior authorization.
• Verifies insurance benefits with insurance companies via phone calls, faxes or internet and documents verification in each patient record, as appropriate.
• Educate patient/guarantor regarding insurance benefits; making arrangements for payment of co-pays, co-insurance and/or deductibles.
• Assist with financial counseling on self-pays.
• Collect payments, issue receipts and reconcile daily receivable activity.
• Responsible for obtaining patient information from other practitioner offices for scheduling and assigns time for exams. Coordinates scheduled exams with mobile and contracted companies.
• Educates outside practitioners and office staff as to ordering outpatient services at CCH.
• Compile and distribute information regarding personal, insurance and financial status.
• Provide appropriate forms to billing and other departments.
• Communicates and coordinates services with internal departments and internal and external practitioner office staff.
• Assists in orientation/training of new employees.
• Conducts audits of the scheduling system to ensure standards are being met when requested.
• Actively participates in developing plans to implement new procedures and processes – working collaboratively with other departments, practitioners and contract services.
• Review and maintain appropriate computer master files: patient master data, guarantor, physician and insurance as well as correlating appropriate manuals.
• Maintain all required records, reports, statistics, etc. Demonstrates creative, critical thinking skills.

Basic Clarke County Hospital (CCH) Performance Criteria

• Focus daily work toward high customer satisfaction. The goal of all employees is to meet or exceed our customer’s expectations 100% of the time.
• Maintain regular and consistent attendance at work.
• Participates in departmental, organizational and mandatory meetings, educational e-mails, etc.
• Actively participates in team oriented decision making process. Is a team player, willing to be flexible and open to ideas of others.
• Requires a high degree of accuracy. Ability to recognize and correct discrepancies.
• Develop a proactive mind set towards the job. Observes opportunities for improvement, formulates ideas, communicates those ideas with their supervisor and/or other staff, and carries out variations in work habits in continuous quality improvement.
• Completes all annual education and competency requirements within the calendar year.
• Demonstrates Clarke County Hospital Standards of Behaviors as well as adheres to hospital and department policies and procedure, infection control, quality assurance, compliance and safety guidelines.
• Reports conduct that is known or suspected to be illegal or in violation of the organizations policies and procedures.
• Brings any questions or concerns regarding compliance to the immediate attention of manager.