The Admitting Rep I is responsible for obtaining and inputting accurate demographic and insurance information, on the Hospital Information System (HIS) on patients, presenting at the various entry points of the Health Center. It is also the responsibility of the Patient Access Admitting Representative to adhere to all departments, hospital, governmental and/or any other healthcare licensing agency requirements related to EMTALA and HIPAA. The Patient Access Admitting Representative will employ effective communication skills, promoting excellent customer service in every interaction. Competency requirements for computer entry, as well as, insurance procedures will be maintained. The Patient Access Admitting representative performs cashiering functions, ensuring that all hospital accounts are secure, through the collection of the required co-pay, deductibles and co-insurance. Perform the medical necessity check, to ensure compliance with Medicare guidelines.
PATIENT AGE GROUP SERVED
Neonate to Geriatric
System and department specific ICARE values
INTEGRITY: We are honest and ethical in all we say and do.
COMPASSION: We embrace the whole person including emotional, ethical, physical, and spiritual needs.
ACCOUNTABILITY: We hold ourselves accountable for all our actions.
RESPECT: We treat every individual as a person of worth, dignity, and value.
EXCELLENCE: We strive to be the best at what we do and a model for others to emulate.
Duties and Responsibilities are cross-referenced to the hospital¿s Pillars of Excellence and will be transferred to the Performance Evaluation
1.Contributes to the departmental and hospital patient satisfaction.
2.Communicates openly in a non-judgmental manner and in a professional demeanor, during all interactions with customers and co-workers.
3.Proactively seeks solutions to address patient issues and concerns. Offers assistance without being prompted and takes the initiative to perform other tasks when the area slows down.
1.Consistently takes the necessary steps to ensure that protected health information remains private and confidential, according to established HIPAA guidelines.
2.Explains the consent forms, obtains signatures on the forms, and responds to any questions in a non-judgmental manner.
3.Practices N-O-D: tells the patients his/her name, explains his/her occupation and what he/she will be assisting the patient with.
1.Obtains and records accurate demographic and insurance information on patients, by interviewing patients, family members and physicians. Ensures that the correct insurance plan codes are utilized for the billing process. Refrains from issuing new medical record numbers to patients with existing accounts and keeps errors to =<1% of total registrations.
2.Attends at least 80% of all department meetings and in-services. Offers suggestions to improve the level of service, customer service, etc. that will improve patient satisfaction scores. Alerts management, in a timely manner, to any unusual and/or difficult situations impacting the level of service.
3.Follows all safety rules while on the job. Reports accidents promptly and corrects minor safety hazards. Completes all hospital required and job related in-services and applies the information needed. Complies with applicable laws, regulation, guidelines and standards regarding safety and infection control issues.
1.Ensures that ordered services meet established medical necessity criteria by performing the PCA (Pathways Compliance Advisor) or any other medical necessity check review, if and when warranted.
2.Collects payments based on pre-determined information provided by the insurance verification team. Absent this information, proactively performs insurance eligibility and verification to ensure reimbursement for services. If applicable, extends payment plans, after the minimum required payment has been received.
3.Accurately posts and receipts patient payments. Balances cash drawer on a daily basis; follows the department policy related to cash drawers and cash receipting.
1.Participates in departmental and hospital performance improvement plans.
2.Completes all hospital required and job related in-services and applies the information as needed.
3.Supports the Admitting team needs when area admission requirements are completed and/or indicated by workdriver.
4.Supports other Admission area needs and collaborates with other departments or other HM hospitals as indicated by workdriver.
This position description is not intended to be all inclusive, and the employee will also perform other reasonably related business duties as assigned by the immediate supervisor and other management as required. The Houston Methodist Hospital reserves the right to revise or change job duties and responsibilities as the need arises.
High School graduate or GED
1 year of registration experience in a hospital environment preferred.
CERTIFICATES, LICENSES AND REGISTRATIONS REQUIRED
SPECIAL KNOWLEDGE, SKILLS AND ABILITIES REQUIRED
¿Computer skills required
¿HBOC-McKesson Healthquest (HIS) experience preferred
¿Microsoft Outlook experience
¿Ability to manage multiple tasks at one time
¿Ability to manage a fast-paced environment
¿Proficient in English, written and verbal