Lead Patient Admission & Registration Clerk

Description

Position Summary: This position serves as a leader for Admissions & Registration Clerks and Patient Benefits Coordinator of Sage Memorial Hospital and Outpatient Clinics, Registration Department for the Greasewood field clinic, by coordinating departmental workload; reviewing the workload and progress of the Patient Registration & Admission staff; train, develop, orientate new employees and assure all demographics and third party resource data is updated and accurate and fulfilling the mission of the Hospital. This list of duties and responsibilities is illustrative only of the tasks performed by this position and is not all-inclusive. Essential Duties & Responsibilities:

• Attend meetings and other meetings as required.
• Communicate with other departments effectively and appropriately, both orally and in writing, to work out solutions to problems or questions related to work.
• Maintain departmental policy and procedure in compliance, subject to administrative approval.
• Prepare department-staffing schedules with approval by the supervisor
• Recommend and implement suggestions for cost containment.
• Evaluate employees on work performance and competency on an annual basis.
• Ensure staff are compliant in meeting due dates for annual mandatory training.
• Provide training to staff that encourages individual accountability and responsibility..
• Assure timely and accurate reconciliation and documentation in registration, patient bio-graphical data, insurance verification, obtaining required authorization, ensure the accuracy and adequacy of documentation.
• Assure that daily admissions and registration are reviewed and obtain all necessary information from patient or responsible party to admit patient into hospital or register for outpatient services.
• Interview patients to determine if patient is new, current or returning; initiate a new or reactivate health record number and account to generate a SMH Claim. Communicate information with the Health Information Management Department regarding reactivation of health record.
• Verify patient identity (State ID, Driver’s License, Birth Certificate, CIB), if patient is a minor, verify minor’s Parents or any Legal Guardianship, Court Order Temporary Custody, Power of Attorney, SMH Consent for Treatment for a Minor Child, if brought in by anyone Page 2 of 4 Position Classification & Description Lead Patient Admission & Registration Clerk other than parents. Communicate and verify with Health Information Management Department.
• Register patient for Clinic or ER accurately. Update all patient’s demographic information accurately and completely at every visit in MEDITECH Expanse Data Base. Obtain and photocopy all required documentation and signatures. Print patient identification band and have patient verify information and place on patient’s wrist. For infant’s place identification band on ankle.
• Provide and explain SMH Condition of Treatment form, Patient’s Bill of Rights (BOR), and the Notice of Privacy Practice (NPP).
• Register and complete patient admission to Inpatient or Observation. Admission information will be provided by inpatient nursing staff by email with date, time, service, physician, and room. Complete all required admission documents, armband, and signature.
• Complete all inpatient discharge according to inpatient nurse email with date, time, and disposition.
• Obtain prior authorization and/or pre-certification for all admission or clinic services.
• Ensure that all inpatient admissions are accurate. Review patient armband for accuracy, admission entry, documentation, verifications, and signatures are complete.
• Verify on every visit all patients Third-Party Insurance Medicaid (AHCCCS), Medicare, and Private/Commercial and Workers Compensation. Update and enter all third-party insurance data in a timely manner in MEDITECH Expanse for accurate billing.
• Set up and/or utilize electronic eligibility system for Third-Party Insurance. Perform telephone verification for Third-Party Insurance that do not provide electronic eligibility.
• Contact patient to verify or provide health insurance cards, obtain photocopies of the card, and explain the verification process to the patient.
• Establish a good working environment with Third-Party Insurance companies, Workers Compensation companies, Patient Benefits Coordinator, Billing and Accounts Payable staff to establish communication and process on corrective actions of discrepancy on claims. Verify and complete all discrepancies.
• Determine the source of discrepancy and implement corrective action as appropriate to ensure that the claim can be processed for payment.
• Verify patient’s information with Third-Party Insurance; policy number, type of coverage, spelling of names, birth dates, and other demographic information are correct. Update all information in patient insurance and guarantor page in MEDITECH Expanse system.
• Verify co-pay, deductible, prior authorization and if policy is in/out of Network with Sage Memorial Hospital. If patient has a co-pay, refer patient to Finance to make payments.
• Provide and work with patients to educate them on their benefit information and coverage as needed.
• Comply with HIPAA and Privacy Practice policy when completing all verifications with thirdparty insurance and workers compensation.
• Complete daily productivity worksheets; registration and insurer verifications.
• Refer all patients without insurance benefits to Public Benefits Coordinator or assist, provide, and explain the AHCCCS application to patient as required. Page 3 of 4 Position Classification & Description Lead Patient Admission & Registration Clerk
• Attend discharge planning meetings as required. Assure patients are greeted in a courteous and professional manner at all times to promote a good public image for the hospital.
• Hold regular meetings with all staff members and develop in-service and educational opportunities that are appropriate for staff.
• Ensure compliance with The Joint Commission standards.
• Participate in long and short range planning for the hospital and implement the hospital mission in daily activities of departments.
• Perform other duties as assigned.
• Distributes and balances the workload among employees in accordance with established workflow, assure timely accomplishments of the assigned workload and assure that each employee has enough work to keep busy.
• Keeps in touch with the status and progress of work and make day to day adjustments in accordance with established priorities, obtaining assistance from the supervisor on problems that may arise, such as backlogs which cannot be disposed of promptly.
• Estimates and reports on expected time of completion of work and maintain records of work accomplishments and time expended and prepare reports as requested.
• Instructs employees in specific task and job techniques and make available written instructions, reference materials and supplies.
• Gives on the job training to new employees in accordance with established procedures and practices.
• Checks on work in progress or spot check work not requiring review and review completed work to see supervisor’s instructions on work sequences, procedures, methods, and deadlines have been met.
• Amends or rejects work not meeting established standards, refer to supervisor questions or matters not covered by standards and problems in meeting performance standards.
• Approves leave for a few hours or for emergencies.
• Resolves simple, informal complaints of employees and refer others to supervisors.
• Reports to supervisor on performance, progress, and training needs of employees and on behavior problems.
  
  

Knowledge, Abilities, Skills, and Certifications:

• Must have knowledge of tactful public relation.
• Must demonstrate knowledge of hospital procedure related to admission & registration.
• Must be able to motivate staff.
• Must demonstrate the ability to develop department goals and objectives. Page 4 of 4 Position Classification & Description Lead Patient Admission & Registration Clerk
• Must have the interpersonal skills to network tactfully and fairly with patients, patients’ families, staff and coworkers.
• Must demonstrate a familiarity with the inner workings of all related departments.
• Must have knowledge in ICD-10-CM Coding.
• Must have knowledge in CPT procedural terminology. Physical Demands: While performing the duties of this job the employee is required to sit for prolonged periods of time and may be required to run errands between other departments. Employee may occasionally need to lift and/or move up to 25 pounds weighted objects. Any necessary accommodations will be made to adhere to organizational, state, and federal guidelines where concerned. Work Environment: Work is generally performed in an office with moderate noise level. Extended hours and irregular shifts may be required, including weekends and holidays.
  
  

Req Number ADM-25-00005

Position Requirements

Minimum Qualifications:

• High School Diploma or General Equivalency Diploma.
• Three (3) years of hospital registration or hospital insurance verification or similar experience required.
• Ability to speak the Navajo language and familiarity with the Navajo Way.
• Must be able to successfully pass the Employee Health Program requirements and background investigation.
  
  

About the Organization Navajo Health Foundation - Sage Memorial Hospital, Inc. is a private, nonprofit 501(c)(3) corporation. It is the first Native-managed private comprehensive health care system in the country, and has been managed since 1978 by an independent, entirely Navajo Board of Directors.

Sage Memorial Hospital is the only Native American hospital to hold both a license from the Arizona Department of Health Services and Accreditation from The Joint Commission.

The hospital campus is located on private land owned by the Presbyterian Church, within the Navajo Nation Reservation. The organization includes a Critical Access Hospital and outpatient clinic, and an outpatient clinic 28 miles away in Greasewood Springs, AZ.

EOE Statement We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status or any other characteristic protected by law.