PAS Pre Registration II at Wellstar Health Systems in Douglasville, Georgia

Job Description:

Facility: Douglas Hospital


Job Summary: Performs Pre-Registration of assigned scheduled registrations. This includes gathering all demographic, insurance, accident information and diagnosis codes. Keeps abreast of third-party regulations. Schedules patients in the proper department for the required procedure. Critical to this position is understanding the revenue cycle and the importance of evaluation and securing all appropriate financial resources for patients to maximize reimbursement to the health system. The Pre-Registration Specialist II is responsible for resolving patient financial issues, including negotiating appropriate arrangements for patient liabilities, recommending approval for charity or other program assistance, etc. Resolves billing issues up front to promote better reimbursement, reduce outstanding revenue and time spent on back end billing functions. Accounts are analyzed for medical necessity specific to payer requirements which can include follow up with physician office for further documentation. Provides conflict resolution between facility and physicians with regards to orders or requests for services. Other duties as assigned. Employees providing direct patient care must demonstrate competencies specific to the population served. Core Responsibilities and Essential Functions: Quality/Safety - Pre-Registers patients accurately and efficiently on computer system - Communicates with all internal and external customers using excellent customer service skills. - Verifies insurance for scheduled patients following guidelines established per payer. - Provides applicable education to patients in preparation for upcoming services Analyzes and interprets several data sources. - Ability to thoroughly communicate patient financial liability prior to service. - Coordinates service between registration, financial counselors and verification/authorization staff - Trains new employees - Perform other work-related duties as requested/directed by management. - Observes work hours and provides proper notice of absences, tardies work schedule changes. - Maintains courteous and cooperative working relationships with WHS management, patients, physicians, other professional contacts, and the public. - Demonstrates ability to tactfully handle difficult situations. - Presents a well-groomed and professional image. - Attends select departmental meetings at the request of WHS Management. - Performs other duties as assigned. Customer Service - Greets all guest with a positive and professional attitude. - Receives patients valuables for safekeeping in the hospital safe. - Answers incoming phone calls and follows through with requests made. - Maintains courteous and cooperative working relationships with WHS management, patients, physicians, other professional contacts, and the general public. Demonstrates ability to tactfully handle difficult situations. - Presents a well-groomed and professional image in coordination with dept/ hospital dress codes. - Expected Performance, Behaviors and Results: - The WellStar Experience (Must demonstrate a commitment to Service Excellence by): - Creating first impressions, memorable moments and impressions that fulfill the expressed and unexpressed wishes and needs of patients and family members. - Valuing patients and family members as partners in their care. - Having world-class processes in place. - Delivering high-touch care that is reliable, responsive and coordinated. - Focusing on constant innovation and creating improvements. - Celebrating our diversity with sensitivity and understanding. - Embracing the idea that we are all owners of our health system. Budget/Financial - Attempts to collect the estimated self-pay balance of all inpatient, outpatient and ER accounts, at the earliest possible collection control point. - Monitors in-house accounts and attempts to make financial arrangements with guarantors for payment of their self-pay balances in full and prior to discharge. - Completes financial evaluation forms to document guarantors' income, expenses, assets and liabilities. - Identifies those patients without adequate insurance coverage. Makes personal contact with patient or guarantor to determine guarantor's ability to pay non-covered charges, as well as to determine potential eligibility for financial assistance programs (namely Medicaid). - Maintains a list of health care financial assistance programs and the eligibility requirements for each program. Refers patients/guarantors to sources of outside funding assistance, as needed. - Works efficiently and accurately within designated time frames to ensure a continuity of information and cash flow. - Contacts scheduled patients at home to obtain pre-admission information, explain financial policies, estimate self-pay balances, and obtain a promise to pay on or before admission/registration. - Interviews all inpatients and select (self-pay) outpatients at time of registration, or at least within 24 hours of admission, to verify complete insurance and financial information, explain financial policies, and collect the estimated self-pay balance. - Documents concise and understandable notes regarding all self-pay account collection activity, as well as each patient or guarantor interaction. Documents all efforts to collect patient account balances, other self-pay collection activities and referrals to Medicaid. - Coordinates financial counseling activities with Admitting, Outpatient Registration, Emergency Registration, Utilization Review, Nursing, Social Services, and Patient Financial Services. - Verifies insurance coverage and benefits. - Exceeds monthly quota on a consistent basis. Formally reports results of self-pay collection activity to direct supervisor, on a daily basis or according to policy. Provides feedback to PAS management concerning self-pay collection and data integrity issues. - Responsible for completion of appropriate error/issues in Work Queues. - Identifies and resolves Payor Denials as indicated. General - Observes work hours and provides proper notice of absences, tardies work schedule changes. - Attends select departmental meetings at the request of WHS Management. - Completes monthly, quarterly, and annual mandatory training as required. - Performs other duties as assigned. - PAS II Team members serve as preceptors and mentors and as such must: - Maintain a based on individual QA audit /or as reported by Epic (min. of 10 accounts) registration accuracy rate or higher in the past 12 months. - Maintain minimum productivity requirements. - Has no corrective disciplinary action during the past twelve (12) months. - Willing and able to function as a preceptor in the orientation of new patient access personnel and students. - Maintain required certifications by obtaining necessary CEUs and submitting timely to certifying board. Required Minimum Education: High school diploma (HSD) Required or GED Required and Associate's Degree Preferred Required Minimum License(s) and Certification(s): All certifications are required upon hire unless otherwise stated.

• Cert Healthcare Access Assoc or Certified Patient Account Rep or Certified Revenue Cycle Rep

Additional License(s) and Certification(s):
Required Minimum Experience: Minimum 1 year experience in healthcare, or institutional work setting Required and Computer/data entry experience. Required Required Minimum Skills: Ability to communicate with various members of the healthcare team. Effective communication skills (both written and verbal), attention to detail, self-directed and a positive attitude are essential. Effective problem solving and critical thinking skills. Working knowledge of patient registration systems and intermediate Microsoft Office Suite are preferred. Epic experience preferred. Apply Now