Employment Type:

Part time

Shift:

Day Shift

Description:

At Saint Alphonsus Health System, we are looking for people who are living out their calling. We want you to be passionate about coming to work, and challenged to achieve your potential. Living by these virtues, we pride ourselves on exceptional service and the highest quality of care.

We are looking to hire a motivated and dynamic Patient Registration Specialist to support our team in Ontario!

Position Details: Schedule for this position will be Part-Time 24 hr/wk.

GENERAL SUMMARY AND PURPOSE:

As a Patient Service Representative, you will work in conjunction with physicians and clinical staff to take care of patients’ administrative needs. Your primary responsibilities would include checking in patients for appointments, collecting patient co-pays, answering telephones, taking accurate messages, scheduling appointments, and checking insurance eligibility. Patient Service Representatives utilize our electronic record system to verify and update patient demographic information as well as posting and balancing of payments collected. Patient Service Representatives are friendly and provide excellent customer service, assuring that patients are informed and well cared for while waiting for their appointment, creating a positive experience for patients.

SKILLS, KNOWLEDGE, EDUCATION AND EXPERIENCE:

• High school diploma or equivalent required.

• Associate degree in Accounting or Business Administration preferred. 

• Prior work experience performing customer service activities within a hospital or clinic environment, an insurance company, managed care organization or other health care financial setting preferred.

• Knowledge of insurance and governmental programs, regulations and billing processes and/or managed care contracts and coordination of benefits preferred. 

ESSENTIAL FUNCTIONS:

• Knows, understands, incorporates, and demonstrates the Organization's Mission, Vision, and Values in behaviors, practices, and decisions. 

• Verifies patient identification, demographic information, and insurance coverage.

• Accepts point of service payments.

• Enters patient information accurately into appropriate hospital information system(s).

• Refers patients with questions regarding financial liability to appropriate resource(s).

• Accepts medical authorization or referral forms, if appropriate.

• Processes key documents to facilitate obtaining insurance information.

• Provides payment estimates for out of pocket costs.

• Educates patients/families on the use of registration kiosks or online systems.

• Identifies routine issues and escalates to Supervisor, Patient Access.

• Processes insurance claim forms.

• Reviews claims/accounts for complete information, corrects and completes forms to ensure accuracy.

• Accesses information and translates data into information acceptable to the claims processing system.

• Prepares claims for return to provider/subscriber if additional information is needed.

• Maintains all appropriate claim files and follows up on suspended or outstanding claims.

• Identifies, researches, and resolves issues related to coordination of benefits, subrogation, and general inquiry issues, then communicates the results.

• Identifies routine payer or provider issues and escalates to Lead Patient Financial Services Representative.

• Acts as a point of contact for assigned payers.

• Maintains compliance with HIPAA and other regulatory requirements throughout all activities. Protects the safety of patient information by verifying patient identity to preserve the integrity of the patient record and ensures all records are complete, accurate, and unique to one patient.  

• Performs pre-registration, insurance verification and financial clearance activities in a variety of settings and for multiple patient types. Communicates frequently with patients/family members/guarantors, and physicians or their office staff in the deployment of key activities.  

• Interviews patients to collect data, initiates electronic medical records, validates and enters data related to procedures, tests and diagnoses.  Determines need for appropriate service authorizations (pre-certifications, third-party authorizations, referrals) and contacts physicians and Care Management/Utilization Review personnel, as needed. 

• Obtains and verifies the accuracy and completeness of