Central Health

Patient Pre-Registration Specialist

Req No.
2022-6436
Company
CommUnityCare Health Centers
Name
Kramer
Address
2115 Kramer Lane, Suite 100
City
Austin
Category
Office & Clerical
State
TX
Type
Regular Full-Time
Shift Days
Mon - Fri
Shift Hours
8am - 5pm

Overview

In collaboration with patients, families (as defined by the patient), and staff across all disciplines and departments, the Patient Pre-Registration Specialist serves as the foundation for CommUnityCare Health Centers care model workflow for new and established CommUnityCare patients.

 

Functions include verifying benefits and eligibility for a multi‐specialty group and facilitating a connection to financial screening services, as needed to support patient access to quality health services. Performs clerical functions, including verifying benefits and eligibility and resolving problems to ensure a clean billing process. Follows up on accounts that require further evaluation. Works with others in a team environment.

Responsibilities

Essential Duties (at least 5 that are non-negotiable duties and are absolutely pertinent to successfully completing the job without accommodations):

 

Primary Accountabilities:

  • Ensure all patients are pre-registered before their visit date of service by contacting via phone to confirm or obtain missing demographic information, quote patient cost share, and instruct patient on where to present at time of appointment.
  • Confirm patient appointments and accurately enter patient data into the electronic medical records software to ensure completeness of patient medical records.
  • Answer all incoming telephone calls document and complete patient registration, provide information as necessary, or reroute the calls as needed.
  • Explain payment options, including sliding scale fees, Medicare, Medicaid, and other forms of payment assistance.
  • Facilitate connection to financial screening services, as needed to support patient access to quality health services.
  • Resolve patient inquiries, including explanation of:

‐ Benefits and eligibility information

‐ Billing and payment options

‐ PCP selection

‐ Specialty clinic protocols and procedures

‐ Authorization for treatment

  • Ensure a positive patient experience through professional interaction with patients and proper phone etiquette.
  • Answer questions from patients, team members, and insurance companies.
  • Verify all commercial, government and state insurance eligibility for medical and dental payers for upcoming appointments by utilizing online websites or by contacting the insurance carriers directly and document results as needed.
  • Performs electronic eligibility through real time eligibility (RTE) when applicable and document results as needed.
  • Review patient deductibles and/or copay/coinsurance and enter the information into the electronic medical records software.
  • Work in conjunction with the billing team and patient access teams to ensure a clean billing process.
  • Help identify and address opportunities for process improvements within EPIC and report findings to Lead Pre-Registration Specialist or Manager.
  • Maintain a positive and flexible attitude, cooperate, and work collaboratively to help others.
  • Embrace diversity throughout the workplace with patients, their families, and co‐workers by making a genuine effort to understand the needs of others.
  • Collaborate with all departments and divisions of CommUnityCare to provide patient‐centered care.
  • Participate in educational activities and attends monthly staff
  • Maintain strict confidentiality of personal health information (PHI) and adhere to all HIPAA guidelines/regulations.
  • Demonstrate a willingness to be an active participant in initiatives that have fundamental impact on the organization.
  • Performs any other duties as needed to drive the vision, fulfill the mission, and abide by the values of this organization.

Knowledge/Skills/Abilities:

Knowledge of

  • Knowledge of administrative and clerical
  • Knowledge of Insurance terminology and verification procedures.
  • Knowledge of Medicare, Medicaid, and Commercial and other third-party insurers.
  • Knowledge of customer service principles and
  • Knowledge of Microsoft Office Applications (Word, Excel, Outlook)
  • Knowledge of HIPAA and Joint Commission guidelines and regulations

Skilled in

  • Possession of problem‐solving skills and sound
  • Possession of organization
  • Excellent verbal and written communication, as well as exceptional interpersonal communication
  • Experience with EPIC PM/EMR system is preferred but not
  • Requires attention to detail and
  • Bilingual (English/Spanish) strongly preferred.

Ability to

  • Ability to utilize computers for data entry, research, and information retrieval.
  • Ability to demonstrate flexibility and ingenuity in response to change
  • Ability to collaborate across departments and build effective relationships with internal and external customers to achieve
  • Ability to achieve team goals while demonstrating organizational values and utilizing resources
  • Ability to read, understand and follow oral and written instructions.
  • Ability to work in a self‐directed, organized manner.
  • Ability to be proactive and take
  • Ability to multitask while maintaining a strong attention to detail and accuracy
  • Ability to exhibit a high level of quality through attention to detail and monitoring of
  • Ability to work independently on assigned tasks, as well as to accept direction on given
  • Ability to deal with confidential information and/or issues using discretion and
  • Ability to have a cooperative work attitude towards co‐employees, management, patients, visitors and
  • Ability to promote favorable company image with physicians, patients, insurance companies, and general
  • Ability to make decisions and solve
  • Ability to follow instructions and to meet
  • Ability to maintain regular and predictable
  • Ability to promptly identify issues and develop action plans for resolution with supervisor.
  • Ability to use organizational resources appropriately and avoids wasteful

 

Qualifications

MINIMUM EDUCATION: High school diploma or GED.

 

MINIMUM EXPERIENCE:

  • 1 year previous experience in registration or front office duties in a physician’s office, hospital emergency department, and/or urgent care setting.

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