Admitting Representative II
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POST DATE 10/12/2017
END DATE 1/6/2018
JOB DESCRIPTIONJob Summary
The Admitting Rep II is responsible for complex patient access activities that facilitate efficient operations, expeditious reimbursement and optimal customer satisfaction. In addition, the Admitting Rep II is responsible for capture of accurate demographics and insurance information. It is also the responsibility of the Admitting Rep II to adhere to all departmental, hospital, government and/or any other healthcare licensing agency requirements related to EMTALA and HIPAA. The incumbent will employ effective communication skills; demonstrate ICARE values in every interaction. Competency requirements for computer entry, as well as, insurance procedures will be maintained. The Admitting Rep II also performs cashiering functions, and promotes the Point of Service collections for the organization which may include collecting prior balances, co-pays, deductibles and co-insurance amounts.
PATIENT AGE GROUP SERVED
Neonate to Geriatric
System and department specific ICARE values
INTEGRITY: We are honest and ethical in all we say and do.
COMPASSION: We embrace the whole person including emotional, ethical, physical, and spiritual needs.
ACCOUNTABILITY: We hold ourselves accountable for all our actions.
RESPECT: We treat every individual as a person of worth, dignity, and value.
EXCELLENCE: We strive to be the best at what we do and a model for others to emulate.
Duties and Responsibilities are cross-referenced to the hospital s Pillars of Excellence and will be transferred to the Performance Evaluation
1. Provides significant input for and assistance with the implementation of team-oriented process improvement initiatives according to assigned protocol.
2. Contributes to the departmental and hospital patient satisfaction and proactively seeks opportunities to improve processes and variables that impact patient satisfaction.
3. Models communication skills and professional demeanor in all interactions with customers and co-workers. Communicates openly in a non-judgmental manner and in a professional demeanor, during all interactions with customers and co-workers.
4. Proactively seeks solutions to address patient issues and concerns; demonstrates skill in defusing tensions and resolving minor disputes with patients or co-workers.
5. Observes area for tasks needing attention or assistance that may be needed during slow periods and initiates efforts among team members to respond appropriately. Offers assistance without being prompted and takes the initiative to perform other tasks when the area slows down.
1. Resolves complex patient issues, including any necessary follow-up to ensure complete resolution. Takes necessary measures to ensure that errors or misunderstandings are not repeated.
2. Interprets and effectively communicates compliance requirements, and insurance guidelines, stipulations, and payment processes, as well as necessary forms and signatures.
3. Consistently protects health information remains private and confidential, according to established HIPAA guidelines.
1. Performs complex patient access transactions and documentation, ensuring accuracy and appropriateness of transactions.
2. Conducts complex registration activity to facilitate efficient patient access, and collaborates with servicing departments and/or clinical professionals to ensure an optimal patient experience.
3. Stays abreast of the most current distributed information regarding third party requirements, and apprises Management when changes or trends significant to reimbursement and patient satisfaction are found in the course of performing daily functions.
4. Thoroughly understands processes and options and responds appropriately to questions about financial concerns.
5. Performs accurate and complete registrations, ensuring all necessary components are included and all concerns are addressed before releasing the patient to the servicing area.
6. Follows all safety rules while on the job. Reports accidents promptly and corrects minor safety hazards. Complies with applicable laws, regulation, guidelines and standards regarding safety and infection control issues.
1. Coordinates and consolidates payer-specific patient access and reimbursement data.
2. Ensures that services trends and compliance issues that surface are brought to the attention of Management in a timely manner. Ensures that ordered services meet established medical necessity criteria by performing the PCA (Pathways Compliance Advisor) or any other medical necessity check review, if and when warranted.
3. Proficiently calculates and skillfully collects payments, fully utilizing all resources and tools at the most effective level. Communicates deficiencies in tools and resources to Management in a timely manner. Collects payments based on pre-determined information provided by the insurance verification team. Absent this information, proactively performs insurance eligibility and verification to ensure reimbursement for services. If applicable, extends payment plans, after the minimum required payment has been received.
4. Accurately posts and receipts patient payments. Balances cash drawer on a daily basis; follows the department policy related to cash drawers and cash receipting.
1. Attends and actively participates in department meetings, in-services and team-building exercises. Initiates and drives team-oriented process improvement actions for the purpose of better serving the needs of the organization and the patients.
2. Participates in departmental and hospital performance improvement plans.
3. Supports the Admitting team needs when area admission requirements are completed and/or indicated by workdriver.
4. Supports other Admission area needs and collaborates with other facility departments or other HM hospitals as indicated by workdriver.
This position description is not intended to be all inclusive, and the employee will also perform other reasonably related business duties as assigned by the immediate supervisor and other management as required. The Houston Methodist Hospital reserves the right to revise or change job duties and responsibilities as the need arises.
1. High School graduate or GED
2. College hours preferred
2 years registration, or related, experience in a hospital environment.
CERTIFICATES, LICENSES AND REGISTRATIONS REQUIRED
SPECIAL KNOWLEDGE, SKILLS AND ABILITIES REQUIRED
Computer skills required
HBOC-McKesson Healthquest (HIS) experience preferred
Microsoft Outlook experience
Ability to manage multiple tasks at one time
Ability to manage in a fast-paced environment
Proficient in English, written and verbal
Equal Employment Opportunity
Houston Methodist is an Equal Opportunity Employer.
Equal employment opportunity is a sound and just concept to which Houston Methodist is firmly bound. Houston Methodist will not engage in discrimination against or harassment of any person employed or seeking employment with Houston Methodist on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, status as a protected veteran or other