Patient Registration Specialist - Phoenix, AZ(Job Number:705302)
Healthcare isn’t just changing. It’s growing more complex every day. ICD-10 Coding replaces ICD-9. Affordable Care adds new challenges and financial constraints. Where does it all lead? Hospitals and Healthcare organizations continue to adapt, and we are vital part of their evolution. And that’s what fueled these exciting new opportunities.
Who are we? Optum360. We’re a dynamic new partnership formed by Dignity Health and Optum to combine our unique expertise. As part of the growing family of UnitedHealth Group, we’ll leverage our compassion, our talent, our resources and experience to bring financial clarity and a full suite of Revenue Management services to Healthcare Providers, nationwide.
If you’re looking for a better place to use your passion, your ideas and your desire to drive change, this is the place to be. It’s an opportunity to do your life’s best work.
Employing excellent customer service skills, the Patient Registration Specialist is responsible for ensuring a positive patient experience throughout the pre-registration, insurance verification, benefit analysis, and financial clearance process. Primary duties include financially securing scheduled procedures prior to the date of service, verifying insurance eligibility and benefits, calculating patients’ financial responsibility, and checking for medical necessity.
- Maintains up-to-date knowledge of specific admission, registration, and pre-registration requirements.
- Ensures the pre-registration process is complete for all assigned accounts at least 5-days prior to the scheduled date of service whenever possible.
- Verifies insurance eligibility and benefits on all assigned accounts using electronic verification systems or by contacting payers directly to determine level of insurance coverage. When contacting payers directly, utilizes approved scripting.
- Obtains referral, authorization and pre-certification information and documents this information in the ADT system.
- When appropriate, ensures the payer receives a Notice of Admission on all admissions, scheduled and non-scheduled, with 24-hours or the next business day.
- Meets CMS billing requirements for the completion of the MSP, issuance of the Important Message from Medicare, issuance of the Observation Notice, and other requirements applicable and documenting completion within the hospital’s information system for regulatory compliance and audit purposes.
- Thoroughly and accurately documents insurance verification and authorization information in the appropriate system, identifying outstanding deductibles, copayments, coinsurance, and policy limitations.
- Understands and follows the “Delay/Defer” policy and escalates accounts that do not meet financial clearance requirements to Patient Registration leadership immediately.
- Verifies medical necessity check is completed for outpatient services when Medicare is the payer
- Responsible for reviewing assigned accounts to ensure accuracy, and to ensure require documentation is obtained and complete.
Job Patient Services
Primary Location US-AZ-Phoenix
Organization O360 Dignity Health Front Ops
Number of Openings 8