Job Openings > Admitting Rep

General Purpose:

This position works in the Main Admitting, Emergency Room and/or others areas as assigned. Under the general direction of the Admitting Manager, this position focuses on registering patients for admission to hospital and/or outpatient procedures and services. This is a key position within Boulder City Hospital that directly affects the patient experience as well as the revenue cycle of the hospital.

Essential Functions:

Admitting Representatives are expected to provide exceptional customer service to all patients, family members, visitors and vendors who come to the hospital to visit or to conduct business. Admitting Representatives are the first people seen when coming into the hospital and set the example for what patients and others will experience while being treated. This position registers patients, verifies patients’ insurance coverage, obtaining insurance pre-authorization when necessary, or on patients coming in when we are not notified in advance of registration for certain types of services not considered emergency services. Admitting Representatives should always communicate to the Admitting Manager and Director Patient Financial Services when insurances change that can affect the business office receiving payments and remits timely. Admitting Representatives are expected to follow EMTALA laws when working in the ER; they should be aware of their role in ensuring patients coming in to be treated are stabilized and treated regardless of their insurance or ability to pay. For emergency services, authorizations are obtained as soon as possible following requirements set by each company and following the Hospital policy. Admitting will also ensure that necessary notifications after normal business hours are followed according to the Admitting standards of practice.

Duties and Responsibilties:

Responsible for answering incoming calls, transferring calls to the appropriate locations, assisting with placement of outgoing calls, contacting individuals by operating the overhead paging system and contacting individuals and agencies in case of an emergency.
Responsible for handling patient inquiries and for directing and providing general information to visitors and the public. Ensure ALL visitors sign into Visitors log and are provided with badge to denote they are a “visitor”.
Logs all patients coming in for labs, radiology and surgery in the “Outpatient Registration” book.
Check census on the system as required. Locate and direct visitors and family to admitted patients.
Reconcile the Admitting/ER Cash Box daily in morning and evening. Process meal ticket requests for employees, take and reconcile cafeteria monies collected from Cafeteria Manager daily, submit to Financial Counselor for deposit daily.
Registers patient for admission to hospital, and/or outpatient procedures. Obtains and verifies all patient demographic information and payment source data, then inputs into computer system. Collect patient payments, issues receipts, reconcile and submit patient payments collected day of or previous day to be submitted to Financial Counselor for deposit. 
Receives requests for admissions and prepares paperwork for nursing personnel. Contacts the appropriate departments of patient’s readiness to be admitted and/or transferred. Enters medical orders into the computer system.
Obtains ALL required signatures on consents and registration forms. Scans into patient’s chart. 
Identifies patient insurance coverage of primary and/or secondary insurance. Scans both the front and backs of insurances so they are legible. Verifies insurance coverage benefits including gaps in coverage, deductible, co-insurance, and out-of-pocket maximum amounts to estimate the out-of-pocket potentially owed by the patient for services. Scans insurance verifications into patient chart for review by billing department. Reports beneficiary coverage issues with patient insurance(s) to Admitting or DPFS to avoid payment issues. Obtains pre-authorizations when required by insurers for payments. Documents in patients chart the authorization details including expiration and services authorized for.
Performs ABN’s as needed to verify covered services vs non covered services. Advises patient when ABN fails so patient is aware of possible out of pocket costs. This will determine if all or a portion of services will be performed. Obtains signed Medicaid and/or Medicare form from patient.

Skills and Abilities Required

Knowledge of insurance verification process, benefits, obtain patient eligibility by phone or insurance website.

Knowledge of insurance benefits and coverage of medical benefit plan to patients (co-pay, co-insurance, deductibles, lifetime benefit, out-of-pocket maximum, CPT codes and Diagnosis codes.

Knowledge of admission process

Must have understanding of EMTALA Federal Law, regulations and guidelines for patients requiring services in the ER.

Must possess good written and verbal communication skills.

Maintains strictest confidentiality and adheres to all HIPAA guidelines and regulations

Education and Experience Required

High School Graduate or equivalent.

Knowledge of medical and insurance terminology.

Prior admitting experience preferred.

Computer knowledge.

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