Reports to the VP Patient Access under general supervision and according to established policies and procedures. Completes the pre-registration which includes collecting accurate demographic and financial information for the purpose of clinical care & revenue cycle reimbursement. In addition, this position provides exceptional customer service during every encounter with patients, families, and BMG associates by communicating with empathy and clarity regarding the details of the next step in care for the customer.

MISSION, VALUES and SERVICE GOALS

• MISSION: We deliver outstanding care, inspire health, and connect with heart.
• VALUES: Trust. Respect. Integrity. Compassion.
• SERVICE GOALS: Personally connect. Keep everyone informed. Be on their team.

Pre-Registration Specialist/Integrated Care duties in accordance with established policies and procedures by:

• Contacting patients to conduct pre-registration using daily work management queues.
• Maintaining productivity standards set within the department.
• Maintaining registration accuracy threshold of 98% as identified in audit processing.
• Accurately identifies patients in the EMR, collects and verifies all information contained within the registration conversation including demographic and insurance information.
• Verifying insurance eligibility using online eligibility system, payer websites or by phone call.
• Identifing and/or determines patient Out of Network acceptance into the organization.
• Reviewing insurance information & provides patient estimates utilizing price estimator products.
• Collecting patient's out of pocket expenses and past balances.
• Meeting individual and department goals.
• Coordinating when necessary the patients who need financial assistance to speak with a Financial Counselor (Navigator).
• Providing explanation for billing procedures, policies and provides appropriate literature and documentation.
• Scheduling, canceling, rescheduling and confirming patient appointments over the phone.
• Following standard of work to determines urgency of patient medical condition when scheduling appointments.
• Scheduling appointment based on the type of visit and insurance coverage requirements along with all test ordered by physician and coordinates appropriately.
• Balancing daily receipts for patient payments.
• Providing exceptional customer-centric service during every encounter with patients, and associates.
• Participating in performance improvement (i.e., follows established work systems, identifies deviations or deficiencies in standards/systems/processes and communicates problems to supervisor or manager).
• Understanding how the flow and rhythm of each task and can connect each resulting in convenient, connected and coordinated care for the patient and/or downstream customer.
• Using numerous software platforms (multiple EMR's, insurance websites, scheduling software, etc.) to conduct tasks for patient care.

Uses the following specialized screening when necessary by:

• Initiating auto accident liability coverage. Identifies all patients involved in an auto accident and obtains all pertinent information regarding medical or non-fault liability and documents in registration/billing systems.
• Initiating ERSD (end stage renal disease) screening. Identifies ESRD patients and obtains all pertinent information regarding coverage by SSI and documents in the registration/billing systems.
• Initiating Veterans Administration eligibility screening. Identifies all VA eligible patients and coordinated admission/treatment with AV and documents in the registration/billing systems.
• Imitating Black Lung SSI screening. Identifies all patients covered under Black Lung and documents in the registration/billing systems.
• Initiating Workers Compensation screening. Accurately identifies all patients seeking treatment for work related injuries. Assists in completion of appropriate paperwork and documents in the registration/billing systems.
• Initiating MSP (Medicare secondary screening).Obtains all information regarding MSP. Documents in registration/billing system all information required on the MSP form.

Performs other functions to maintain personal competence and contribute to the overall effectiveness of the department by:

• Enhancing professional growth and development through in-service meetings and educational programs as approved.
• Assisting others and/or accept additional duties.
• Maintaining up-to-date knowledge and stays abreast of changes and updates as they occur. (Includes but not limited to, insurance, department and processes changes.

ORGANIZATIONAL RESPONSIBILITIES

Associate complies with the following organizational requirements:

• Attends and participates in department meetings and is accountable for all information shared.
• Completes mandatory education, annual competencies and department specific education within established timeframes.
• Completes annual employee health requirements within established timeframes.
• Maintains license/certification, registration in good standing throughout fiscal year.
• Direct patient care providers are required to maintain current BCLS (CPR) and other certifications as required by position/department.
• Consistently utilizes appropriate universal precautions, protective equipment, and ergonomic techniques to protect patient and self.
• Adheres to regulatory agency requirements, survey process and compliance.
• Complies with established organization and department policies.
• Available to work overtime in addition to working additional or other shifts and schedules when required.

Commitment to Beacon's six-point Operating System, referred to as The Beacon Way:

• Leverage innovation everywhere.
• Cultivate human talent.
• Embrace performance improvement.
• Build greatness through accountability.
• Use information to improve and advance.
• Communicate clearly and continuously.

Education and Experience

• The knowledge, skills, and abilities as indicated are normally acquired through the successful completion of a high school diploma or equivalent; two or more years of previous work experience in insurance, medical records, coding, billing or related area to develop knowledge of healthcare revenue cycle. Knowledge of medical terminology & ICD-10 codes, knowledge of insurance verification process, and third-party payor's, strong communication skills, both written and verbal, experience with computers and other office equipment, good organizational and analytical ability; must be detail oriented, proven customer service skills, along with commitment to patient satisfaction, working knowledge of Microsoft Office: Outlook, Excel and Word.

Knowledge & Skills

• Demonstrates well-developed communication skills to communicate effectively and clearly to a variety of internal and external contacts.
• Demonstrates analytical skills necessary to solve problems and interpret data.
• Promotes collaboration and innovation in the clinical services to ensure an interdisciplinary approach to improving healthcare delivery and the quality of patient care.
• Must be tactful in communicating problems which are often of a highly personal and confidential nature.
• Must be able to maintain professionalism during potential frustrating interpersonal situations.
• Demonstrates a high knowledge level of procedures, including knowledge of CPT codes and ICD-10 Codes.
• Demonstrates a high knowledge of insurance network guidelines to ensure the referral is scheduled in accordance with customer's insurances rules and regulations.
• Ability to type 55-65 WPM.
• Using critical skills to make decisions, identify problems, create solutions and helping to implement change.
• Escalates concerns when necessary.
• Effectively prioritizing work.
• Working at a fast pace and maintaining accuracy.

Working Conditions

• Assigned hours within your shift, starting time, or days of work are subject to change based on departmental and/or organizational needed.
• Evening hours may be required.
• Working space is frequently congested by other personnel.
• Constantly exposed to noise and distraction.

Physical Demands

• Requires the physical ability and stamina to perform the essential functions of the position.
• Sitting for long periods of time in front of a computer monitor.