ADMISSIONS & PATIENT REGISTRATION CLERK

Position Summary: 
This position performs registration and admission flow for inpatient and outpatient. Updates patient demographic information, ensures accurate patient data is collected. Verifies insurance information, obtains prior authorization and required signatures and fulfills the philosophy of the hospital.

This list of duties and responsibilities is illustrative only of the task performed by this position and is not all-inclusive.

Essential Duties & Responsibilities:
•    Greet and provide professional and courteous customer service to all patients, families, visitors and employees.
•    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 other than parents. Communicate and verify with Health Information Management Department.
•    Register patient for the Outpatient Clinic, Ancillary Clinics, or Emergency Department accurately. Update all patient’s demographic information accurately and completely at every visit in the MEDITECH Expanse Data Base. Obtain and photocopy all required documentation and obtain signatures. 
•    Provide and explain SMH Condition of Treatment,, 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’s email with date, time and disposition.
•    Obtain prior authorization and/or pre-certification for all admissions and ambulatory  services when necessary
•    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 policies when completing all verifications with third-party insurance..
•    Complete daily productivity worksheets; registration and insurer verifications.
•    Refer all patients without insurance benefits to Patient Benefits Coordinator or assist, provide and explain the AHCCCS application to patient as required.
•    Performs Scheduling of appointments and rescheduling as needed, following the procedures and guidelines of the department they are working in. 
•    This position requires availability for rotating shifts, including day, night, and holiday coverage, across a seven-day workweek. Flexibility and reliability are essential, as schedules may vary to meet operational needs.
•    Perform other duties as assigned.
 

    Minimum Qualifications: 
•    High School Diploma or General Equivalency Diploma.
•    Two (2) to Three (3) years of clerical experience in a healthcare or hospital setting preferred. 
•    Must be able to successfully pass the Employee Health Program requirements and background investigation.

    Knowledge, Abilities, Skills, and Certifications: 
•    Ability to communicate well in both English and Navajo.
•    Ability to maintain professional attitude.
•    Ability to work efficiently, show compassion, be considerate, be tactful and pleasant.
•    Ability to use the computer, as well as operate necessary office equipment.
•    Be able to perform job duties with minimal or no supervision.
    
    
    
    Physical Demands: 
While performing the duties of this job, the employee regularly is required to sit; use arms and hands to reach and grasp objects; talk and hear. The employee frequently is required to walk. The employee occasionally is required to stand; and stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 25 pounds.
    
    Work Environment: 
    Work is generally performed in an office with moderate noise level. Day shift, evening shift, night shift, work holidays and weekends. Extended hours and irregular shifts may be required.