General Summary of Position Responsibility:
Registers patients for future ambulatory appointments. Obtains timely and accurate demographic and insurance information. Performs eligibility verification for ambulatory patients. Responds to inquiries regarding services at Lurie Children’s. Informs patients of financial responsibility based on scheduled appointments.
Essential Job Functions:
- Obtains all demographic and financial information by interviewing parents via telephone to create and complete registration process. Accurately creates and updates registration data for patients.
- Manages registration call center incoming calls, responds to general questions regarding services available at the medical center, Lurie Children’s satellites and gives directions to all Lurie Children’s locations.
- Completes registration call center outbound calls to proactively attempt to contact patients regarding their upcoming appointments and registration/insurance update needs.
- Maintains knowledge of managed care/insurance requirements by attending educational sessions.
- Provides details to patients on managed care enrollment process for commercial, marketplace and government based insurance options.
- Verifies insurance eligibility prior to the patient visit. Identifies need for insurance authorization or referral and instructs family to obtain insurance authorizations for service when needed.
- Identifies issues regarding consent for treatment and advises caregivers about obtaining consent from appropriate agencies.
- Identifies patients needing financial counseling and refers to Business Associates.
- Collaborates with clinic point of service (POS) and facilitates the registration/insurance verification process.
- Works with family and division office staff to resolve issues around insurance denials.
- Recognizes need for caller to be referred to a Kids Doc nurse or division office for further assistance.
- Performs job functions adhering to service principles with customer service focus of innovation, service excellence and teamwork to provide the highest quality care and service to our patients, families, co-workers and others.
- Performs other related duties as assigned.
Specific to Area Job Functions
Call center Registrar:
- Answers all incoming calls into the registration call flow.
- Complete all registrations during calls with patients/families on inbound and outbound assignments.
- Monitors the Avaya call back assist function in the call center.
- Completes all online registrations submitted by families.
- Collaborates with interpreting services for non-English speaking patients.
- Ensure all demographic, insurance, emergency contact and appointment information is updated and verified with caller.
- Merges guarantors, corrects duplicate patient records and initiates name corrections and DOB corrections with HIM.
- Verify parental consent details and verify legal custody documents with callers to ensure patient records are up to date.
- Provides details on managed care enrollment process for commercial, marketplace and government based insurance options.
- Email and text patient’s appointment reminders at their request.
- Communicate rescheduling details back to the division offices and send out of network and self-pay notices to the divisions.
Insurance verification Registrar:
- Runs eligibility queries for upcoming patient appointments.
- Assists with registration calls.
- Collaborate with the call center registrars to verify eligibility on appointments that cannot be E-verified in Epic.
- Entering in insurance referrals into Epic.
- Create and register all Tele-echo patients and create early intervention authorizations.
- Contact insurance companies as needed to verify patient’s active coverage and benefit details.
- Takes calls from division staff and patients needing additional details on insurances Lurie accepts, referral requirements and out of network benefit options. Send out of network and self-pay notices to the divisions.
- Complete all of the patient creation and patient registration details for all Outreach hospitals.
- Manage the baby names process for Outreach hospitals that see newborns.
- Coordinate with outreach hospitals on capture of final names for new born babies.
- Coordinate with Outreach hospitals on demographic issues related to incomplete information received in registration batches.
- Manages the CIN registration process.
Knowledge, Skills and Abilities:
High school graduate required; BS or BA preferred. Excellent communication/listening skills. Customer centric approach to engaging with patients and families. Ability to make quick accurate decisions on a daily basis. Ability to handle stressful situations. Knowledge of medical terminology, third party billing, and managed care requirements. Knowledge of commercial, marketplace and government managed care products and services. Proficient computer skills and aptitude. Problem solving ability and able to handle multiple priorities.