Job Description

Works with both internal and external customers to ensure efficient and accurate patient entry into the hospital system, oversees physician schedules, and coordinates endoscopy procedures. Performs patient pre-registration and registration, insurance verification and obtaining necessary authorizations, educating patients on procedures and financial responsibilities, and ensuring all required paperwork is completed and distributed correctly.

Responsibilities

• Works with internal and external customers to efficiently and accurately enter patients into the hospital system.
• Monitors the physicians and books the patient accordingly.
• Promptly arranging the physician schedules according to their booked Outpatient Department (OPD) and endoscopy appointments.
• Works with internal and external customers to efficiently and accurately enter patients into the hospital system, per departmental policies and procedures.
• Greets patients and pre-registers/registers patients promptly, professionally, and efficiently, per departmental policies and procedures.
• Follows the National Patient Safety Goals regarding patient identification.
• Avoids the use of medical jargon when speaking to patients and families.
• Requests cost estimates and educates the patients about possible financial responsibilities to be addressed upon a visit to the hospital.
• Educates patients about the preparation and guides them through the steps they need to take to perform endoscopy procedures.
• Books anesthesiologists visit and coordinates accordingly before the scheduled procedures.
• Follow up on approval statuses, insurance requests and orders by the physicians on the system.
• Acts as the mediator and coordinator between the nurses, physicians and endoscopy departments
• Explains forms and secures all patient signatures for required documents.
• Ensures that all paperwork is sent to the appropriate departments.
• Aids patient/family in getting to the clinical area.
• Answers phone utilizing proper Departmental standards.
• Speaks to patients/family members using age/culturally appropriate techniques.
• Recognizes potential changes related to ageing and/or stress, (i.e. diminished vision/hearing, decreased stamina, confusion, and intervenes appropriately).
• Contacts physicians or ancillary departments to resolve questions.
• Runs sanction checks on all ordering physicians not currently in doctor master, if necessary
• Communicates with the registration team to make sure the patient is preregistered and or registered properly to not cause any technical challenges.
• Clears the queue list of all request orders about endoscopy procedures.

Insurance:

• Verifies and obtains insurance benefits and required referrals and pre-certifications for patients that have not been pre-registered before the patient is treated, immediately after the patient arrives, or, if necessary, within one business day of the patient’s treatment
• Follows departmental policies and procedures for completing the patient’s record, including copying insurance cards (or indicating in the system when insurance card is unavailable), entering authorization/pre-certification/referral numbers, and other information as necessary.
• Verifies insurance coverage through an automated eligibility system. Uses insurance verification systems to verify eligibility and upfront collection amounts.
• Communicates and explains insurance benefits and coverage information to patients.
• Contact the patient’s insurance carrier to obtain benefits within 24 hours of the service date and determine if pre-certification or referral from a Primary Care Physician is required.
• Refers inpatient accounts to Care Coordination for clinical justification for precertification as necessary.
• Maintains contact with physician practice offices to process insurance eligibility and pre-certifications.

Outpatient Registration:

• Monitors insurance coverage to ensure patients are capitated to the hospital.
• Ensures the patient has the required forms for Ancillary Services being rendered. If needed, directs patients to the proper area for the test.
• Verifies that a secured authorization and referral are on file if necessary.

Customer Service and Problem Solving:

• Meets the needs of the patient, physician, physician office, and internal colleagues by maintaining good public relations skills:
• Utilizes the Acknowledge, Introduce, Duration, Explanation, Thank You (AIDET) model during every patient encounter.
• Strives to please the patient, physician, physician’s office, and internal colleagues at all times.
• Always greet the customer with a smile and address the customer by name in a courteous, respectful and professional manner.
• Attempts to understand customer questions and concerns. If unsure of the answer, seeks information from the appropriate person to assist the customer.
• Files all documents as needed.
• Identifies and solves client problems.
• Receives problem/question calls from clients, determines action needed, and monitors the problem to complete resolution.
• Addresses critical problems, otherwise communicates unresolved problems to the appropriate individuals as soon as possible.

Endoscopy Unit Greeter & Registration:

• Registers patients using the correct location.
• Answers the telephone utilizing Departmental Scripting.

Scheduler Responsibilities:

• Arranges for speciality equipment and/or vendors as designated when scheduling.
• Conducts pre-procedure telephone calls to scheduled outpatients to confirm appointments.
• Escalates late case cancellations.

Clerical Duties:

• Utilizes the Electronic Medical Record (EMR) to enhance communication.
• Communicates transfer of the patient.
• Answers the phone in a professional manner, stating full name and unit.
• Takes and delivers messages accurately and in a timely fashion.
• Devotes appropriate time and effort towards the development of new staff members.
• Exhibits flexibility as needed in daily work and activity.
• Demonstrates willingness to assist co-workers effectively and positively.

Qualifications

• Highschool Graduate

PROFESSIONAL EXPERIENCE:

• Minimum of two (2) years of experience in a private hospital preferred.
• Knowledge of Medical Terminologies.
• Knowledge and experience with customer service principles.
• Knowledge of insurance eligibility portal systems.
• Skills in computer applications such as Microsoft Office (e.g. Word, Excel, PowerPoint, Outlook, etc.).
• Ability to speak and write in English fluently.