RCM Representative Senior, Admitting and Registration

Full Job Description

SUMMARY:
We are currently seeking an RCM Representative Senior to join our Admitting and Registration team. This 0.50 FTE (40 hours per pay period)  role will primarily work on-site (SHIFT: Days and Every Other Weekend) .  

Purpose of this position: Working under general supervision, provides revenue cycle services to incoming and existing patients and their families either in person or by telephone. Is responsible for gathering patient information needed to provide services such as following up on complex claim issues, financial clearance, customer service, or admission. Works will be assigned via a work queue in the electronic health record system

A $1000 hiring incentive is available for eligible external candidates (current employees, contract/temporary workers, and former employees returning to HHS within one year are ineligible).

RESPONSIBILITIES:

• Gathers information from patients, clients/family members, HCMC clinical areas, government agencies, employers, third party payors, and/or medical payment programs, etc. both in-person and by telephone to register patients, gather or update information, obtain referrals and pre-authorizations, complete appropriate forms, conduct evaluations, determine benefits and eligibility (insurance, public programs, etc.), determine financial responsibility, and/or to identify sources of payment for services
• Requests, inputs, verifies, and modifies patient’s demographic, primary care provider, and payor information
• Utilizes tools, including computer programs, when indicated
• Makes appropriate referrals (i.e. Patient Financial Care Specialists, Collections Specialists) as appropriate
• Provides excellent customer service and timely response to questions and issues related to benefits, billing, claims, payments, etc.
• Answers questions (by phone and in-person) and provides quotes for services (including discounts), identifies financial resources, etc. in accordance with HCMC policies and procedures
• Utilizes various databases and specialized computer software for financial care activities including eligibility verifications, pre-authorizations, medical necessity, review/updating of patient accounts, etc.
• Establishes plans (patient liabilities, payment, etc.) and conducts follow up activities related to those plans
• Inputs, retrieves, and modifies information and data stored in computerized systems and programs; generates reports using computer software
• Explains charges, answers questions, and communicates a variety of requirements, policies, and procedures regarding patient financial care services and resources to patients, staff, payors, and agencies
• Works with Claims and Collections (both internally and with collection agencies) in order to assist patients and their families with billing and payment activities in order to increase cash flow
• Other duties as assigned