PATIENT REGISTRATION LEAD

Job Summary and Responsibilities
As a Patient Registration Representative, you will ensure a positive patient experience during registration, employing excellent customer service.

Every day you will identify patients, collect accurate demographics, verify insurance, determine/collect financial liability, and explain hospital policies and patient rights to families.

To be successful, you will demonstrate exceptional customer service, meticulous attention to detail in data/insurance, and strong communication, crucial for patient satisfaction and reimbursement.

• Registration Review and Financial Clearance
  
  
  
  
  
  • Interviews patients to obtain, clarify, and verify all demographic and insurance information not previously gathered.
  
  
  
  • Identifies and corrects any errors found in the registration information.
  
  
  
  • Reviews insurance verification information and account notes entered by the Patient Registration Representative and/or Registration. Ensures any missing information is captured. As necessary, verifies patient's insurance coverage, determines benefit levels, reviews level of services, and calculates patient's financial liability.
  
  
  
  • Explains the Payment and Billing Assistance Program to all patients regardless of financial concerns or limitations.
  
  
  
  • Identifies outstanding balances from patient's previous visits and attempts to collect any amount due.
  
  
  
  • Provides referral to external agencies and/or third party vendors which may provide financial assistance, including state and government based programs.
  
  
  
  • Assists patient with the completion of payment assistance program applications.
  
  
  
  • Assesses a patient's ability to meet their financial liability and assists with arranging payment plans as needed.
  
  
  
  • Thoroughly and accurately documents conversations with patients regarding agreement to payment plans. Obtains necessary signatures.
  
  
  
  • Meets CMS billing requirements for the completion of the MSP, issuance of the Important Message from Medicare, issuance of the Observation Notice, and other requirements as applicable and documenting completion within the hospital's information system for regulatory compliance and audit purposes.
  
  
  
  • For patients who qualify, offers a flat rate discount based on estimated charges and/or percent reimbursement, or following facility specific policy and procedures.
  
  
  
  • Ensures that insurance verification and benefit information is completed and documented on all urgent/emergent admits within 24 hours of service (or next business day).
  
  
  
  • Interviews self-pay inpatients within 24-hours to identify potential eligibility for government aid and/or other payer sources. Gathers applicable documents for the application process and follows appropriate policy when referring to eligibility vendors.
  
  
  
  • Assesses self-pay patients for Medi-Cal/Medicaid presumptive eligibility and when appropriate, initiates the process.
  
  
  
  • Provides financial clearance services to self-pay patients prior to discharge or within 24-business hours of discharge.
  
  
  
  • Provides on-site customer service for walk-in patients with billing-related questions.
  
  
  
  • Provides information to hospital personnel who are seeking answers to financial concerns on their patient's behalf.
  
  
  
  • Works closely with Case Management, Health Information Services, Social Work Services and physician offices to ensure appropriate and HIPAA compliant information sharing regarding insurance coverage and financial assistance options.
  
  
  
  • Understands and follows the facility's Delay/Defer policy and procedure escalating accounts that do not meet financial clearance requirements appropriately and timely.
  
  
  
  • Responds timely to requests for assistance from Patient Registration areas, Case Management, clinical areas, etc.
  
  
  
• Verification, Authorization, and Compliance
  
  
  
  
  
  • As needed, follows the approved scripting when verifying insurance benefits, deductibles, copayments, co-insurance and policy limitations.
  
  
  
  • Reviews insurance information and verification notes on all inpatient admissions and OP surgery patients. Obtains missing information, corrects errors as needed and updates the account appropriately. Reports incidents of missing or incorrect data capture to the Director of Patient Registration.
  
  
  
  • Ensures division of financial responsibility is clearly identified in financial clearance notes if payment for services is split between a medical group and an insurance company.
  
  
  
  • When collecting patient payments, follows policy and procedure regarding applying payment to the patient's account and providing a receipt for payment.
  
  
  
  • When needed, verifies medical necessity check has been completed for outpatient services. If not completed and only where appropriate, uses technology tool to complete medical necessity check and/or notifies patient that an ABN will need to be signed. Identifies payer requirements for medical necessity.
  
  
  
  • Ensure notice of admission is communicated to the payer as necessary.
  
  
  
  • When needed, works closely with Case Management/Utilization Review in ensuring services are appropriate for level of care provided (inpatient vs. outpatient and vice versa).
  
  
  
  • Complies with HIPPA, PHI and its implications, ABN, MSP, EMTALA, etc. and other regulations which affect the registration process.
  
  
  
  • Acts as resource to other hospital departments regarding insurance benefits and requirements and collaborates with other departments, as needed, to ensure proper compliance with third party payer requirements.
  
  
  
  • Provides on-site customer service for walk-in patients with billing-related questions.
  
  
  
  • Carefully documents all interactions with patients in the ADT system for future reference and/or legal matters.
  
  
  
  • Responsible for reviewing assigned accounts to ensure accuracy and required documentation is obtained and complete.
  
  
  
  • Works with physician offices and clinical area to share and collect patient information, and to help update these stakeholders on changes in patient registration requirements, processes and programs.
  
  
  
• Lead Responsibilities
  
  
  
  
  
  • Maintains up-to-date working knowledge and oversight of all registration areas to provide coverage as needed.
  
  
  
  • Understands the department's Key Performance Indicators and performs quality review of registration data accuracy, POS collections, productivity, absenteeism and other metrics.
  
  
  
  • Assists with generating KPI reporting for review with the Registration Management team.
  
  
  
  • Assists the Registration Leadership with developing the staff schedule following department and union (where appropriate) policy and procedure.
  
  
  
  • Assists Registration Leadership with ensuring all shifts are adequately covered in the event of vacation, unscheduled sick, medical leave of absence and other time off occurrences.
  
  
  
  • If applicable to specific facility, assumes on-call responsibility and duties for evenings, weekends and holidays.
  
  
  
  • Daily management of shift cash drawers and deposits.
  
  
  
• Other Duties
  
  
  
  
  
  • Understands and follows Cashier policy and procedures.
  
  
  
  • Properly handles credit card transactions in accordance with PCI-DSS standards and guidelines. Will have access to both single card transactions as well as access to data from multiple transactions or reports and files containing bulk transactional information containing un-encrypted or un-redacted credit card information
  
  
  
  • Inventories and stores patient's valuables following proper procedure where appropriated by facility.
  
  
  
  • Works with physician offices to ensure understanding of changes and/or updates to Patient Registration requirements, processes or programs.
  
  
  
  • The above statements reflect the general details considered necessary to describe the essential functions of the job as identified, and shall not be considered as a detailed description of all work requirements that may be inherent in the position.
  
  
  

Job Requirements
Required

• High School Graduate General Studies, upon hire or
• High School GED General Studies, upon hire and
• Minimum 3 years of experience working in a hospital Patient Registration Department, physician office setting, healthcare insurance company, revenue cycle vendor, and/or other revenue cycle role and
• Applicable education and/or training can be used to balance a lack of experience. Experience in requesting and processing financial payments and
• Minimum 2 years of experience in customer service, preferably in a healthcare environment. and
• None, upon hire

Preferred

• Associates Other and 4 to 5 years experience working in a hospital Patient Registration Department, physician office setting, healthcare insurance company, revenue cycle vendor, and/or other revenue cycle role. , upon hire and
• One or more years of supervisory experience

Where You'll Work

Founded in 1910, Dignity Health - Mercy Hospital is a 229-bed, acute care, nonprofit hospital located in Bakersfield, California. Serving nearly 90,000 patients annually, the hospital offers a full complement of services including Level II NICU, cancer care, women’s health, and orthopedics. Additionally, Mercy Hospital Downtown & Mercy Hospital Southwest have been recognized as an LGBTQ+ Healthcare Equality High Performer by the Human Rights Campaign Foundation. They are both Joint Commission-certified Primary Stroke Centers. Mercy Hospital Downtown offers the only inpatient Oncology Unit in Bakersfield while Mercy Hospital Southwest has the only Obstetric Emergency Department in Bakersfield.

One Community. One Mission. One California