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Summary of Essential Functions :
Educational Requirements :
Qualifications / Knowledge / Skills / Abilities :
Duties and Responsibilities :
Follows policy and procedures that govern the naming conventions, search practices and notification of changes to the MPI core data elements.
Utilizes all systems available to verify information provided by patients / families. This includes collecting a copy of the patients(s) or guarantor's drivers' license(s) and insurance card(s).
Inputs third party payer information, according to what plan is considered primary payer, secondary payer, etc. Establishes the correct assignment of payer based on COB training materials.
The department sets performance targets associated with write offs, denials and rejections. The target must be achieved in order to meet performance expectations.
To provide the highest possible customer service, patients are preregistered 2 working days to 2 weeks in advance of appointment / admission date daily.
Contacts insurance company(ies) and notifies them of the patient's admission within next business day of admission and / or in accordance with Payer's contracted guidelines.
Works with Utilization Review department and physician's offices to ensure that clinical requirements are obtained. Enters all benefits and pre-cert information in the account notes as instructed.
Provides efficient documentation of time and person whom talked to when obtaining benefits and pre-certification data.
Based on benefit information obtained from the patient's insurance company, creates an accurate good faith estimate letter.
Utilizes all available resources to obtain CPT & Procedure Codes i.e. CPT / Procedure Code books, websites, Medical Records Coding Help Line ect.
Provides patient / family with information on advanced directives, patient rights, consent for treatment, and obtains appropriate signatures.
Prepares necessary patient packets and completes charts. Scans insurance cards, patient identification cards, and other admitting documents.
Quotes patient's co-share responsibility (co-payments, deductibles, & out of pocket amounts) to patient, negotiates payment options that lead towards compliance and minimizes collection expenses.
Provides assistance applications to all patients with no or inadequate funding.
Documents receipts of funds from patient and gives copy to patient at time of transaction. Files receipt of funds in department files.
Reconciles petty cash count and reports overage / shortage to supervisor daily.
Will follow established procedure to ensure that Medicare Secondary Payer Questionnaire (MSPQ) are collected and accurately entered into the registration system.
Will insure that Medicare A and / or Medicare B, along with any other applicable coverage, are shown in the correct position(s) on the Insurance Plan Screen in Eclipsys, and if not, to make the appropriate corrections.
Completes special assignments completely and in a timely manner, is quick to assist, demonstrates ability to work under deadlines and pressure.
Works with Management in a positive manner when reporting trouble accounts.
Performs all other tasks / responsibilities as necessary.
PI242592748
Last updated : 2024-06-22
Full Time
Ambulatory Healthcare Services
$37k-50k (estimate)
06/24/2024
06/26/2024
unitedregional.org
WICHITA FALLS, TX
1,000 - 3,000
Private
ARIF MAHMOOD
$200M - $500M
Ambulatory Healthcare Services
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