Admissions Specialist I | PRN

Sioux Center Health; Sioux Falls (SD); On-site; USD 25,000 - 32,000; Full time

Job summary

Avera McKennan Hospital is seeking an Admissions Specialist to register patients and establish accounts. You will verify insurance, collect co-pays and deductibles, and handle pre-certifications and authorizations for assigned accounts.

The role requires accurate data entry, HIPAA compliance, and effective communication with patients and hospital staff. 12-hour shifts and rotating weekends are possible as part of the schedule.

Qualifications

• High School or GED equivalent required.
• Healthcare experience is preferred.
• 1-3 years related experience in billing, insurance or registration is preferred.

Responsibilities

• Register patients in a timely and accurate manner and establish accounts and medical record numbers.
• Verify insurance coverage and collect patient co-pays, deductibles, and out-of-pocket expenses.
• Complete insurance verifications, pre-certification and/or authorization for assigned accounts.
• Coordinate communications with patients, staff, providers and external financial agencies.

Education

High School or GED Equivalent

Job description

Pay Range

The pay range for this position is listed below. Actual pay rate dependent upon experience.

$18.00 - $23.25

Location

Avera McKennan Hospital

Worker Type

Regular

Work Shift

As Needed (United States of America)

Position Highlights

12 hour shift: 7:0 AM-7:0 PM or 7:0 PM-7:0 AM with rotating weekends

You Belong at Avera

Be part of a multidisciplinary team built with compassion and the goal of Moving Health Forward for you and our patients. Work where you matter.

A Brief Overview

Responsible for registering patients in a timely and accurate manner while performing all necessary procedures to establish accounts and medical record numbers. The Admissions Specialist verifies insurance coverage and limitations and collects patient co-payments, deductibles and out-of- pocket expenses and communicates this to the patient. The Admissions Specialist completes insurance verifications, pre-certification and/or authorization for assigned accounts.

What You Will Do

• Performs all necessary procedures to create accounts/medical record number and insurance coverage and limitations in a timely and accurate manner as well as coordinates communication with patients, employees, providers, and external financial agencies.
• Registers patients in a timely and accurate manner by entering demographic, insurance, physician, and other defined information while following established registration standards; assists Patient Care staff with bed assignments based on patients diagnosis, age, and condition; assists in monitoring the quality and efficiency of the registration process including completing follow-up on incomplete registrations through bedside registration.
• Strives to meet Point of Care collection initiative by generating patient estimates, educating patients at the time of service and/or pre-calling on their individual plan benefits and identifying specific account goals for collection based on deposit matrix/patient estimator tools. Requests and accepts deposits towards deductible and/or coinsurance amounts from patients based on current deposit matrix/patient estimator tools and posts payments correctly to the payment processing system.
• Maintains customer relations at a very positive level as evidenced by feedback from patients, visitors, physicians, patient care units, and fellow employees. Ensures all patients are offered a Patient’s Rights Brochure, understands the admission consent form, and have been informed of the hospital’s privacy practices (HIPAA).
• Coordinates internal hospital messages, imports continuity of care documents (CCDS) and answers telephone promptly and courteously and immediately addresses caller’s needs. Completes insurance verification, pre-certification/authorization for assigned accounts.
• Interacts with the patient while in Patient Care units in order to complete registration (obtaining consents, inform patients of telephone consumer protection act, insurance information, referring physicians, and CMS required documentation) such as IMMs, MOON, and OBVs, etc.
• Checks for medical necessity by confirming CPOM order and status of care at time of admission for direct admits.

Essential Qualifications

The individual must be able to work the hours specified. To perform this job successfully, an individual must be able to perform each essential job function satisfactorily including having visual acuity adequate to perform position duties and the ability to communicate effectively with others, hear, understand and distinguish speech and other sounds. These requirements and those listed above are representative of the knowledge, skills, and abilities required to perform the essential job functions. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job functions, as long as the accommodations do not cause undue hardship to the employer.

Required Education, License/Certification, Or Work Experience

• High School or GED Equivalent

Preferred Education, License/Certification, Or Work Experience

• Healthcare experience
• 1-3 years related experience in billing, insurance or registration

Expectations and Standards

• Commitment to the daily application of Avera’s mission, vision, core values, and social principles to serve patients, their families, and our community.
• Promote Avera’s values of compassion, hospitality, and stewardship.
• Uphold Avera’s standards of Communication, Attitude, Responsiveness, and Engagement (CARE) with enthusiasm and sincerity.
• Maintain confidentiality.
• Work effectively in a team environment, coordinating work flow with other team members and ensuring a productive and efficient environment.
• Comply with safety principles, laws, regulations, and standards associated with, but not limited to, CMS, The Joint Commission, DHHS, and OSHA if applicable.

Avera is an Equal Opportunity Employer - Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, Veteran Status, or other categories protected by law. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-605-504-4444 or send an email to [e-mail].