Insurance Verifier

St. Josephs Medical Center; Houston (TX); On-site; USD 36,000 - 48,000; Full time

Job summary

St. Joseph Medical Center in Houston seeks an Admitting Registrar to ensure accurate patient registration and smooth handoffs to clinical departments. The role interviews patients, collects demographics, verifies insurance eligibility, and handles pre-certifications at the point of service.

This position emphasizes HIPAA compliance, bedside registration when needed, and contributing to a positive patient experience while meeting turnaround times and upfront collection goals.

Qualifications

• 2-3 years of registration or comparable work experience.
• High school diploma or GED required.
• Familiarity with HIPAA guidelines and patient privacy.

Responsibilities

• Register patients accurately and timely, recording demographics and financial information.
• Obtain insurance eligibility and perform pre-certifications/authorizations.
• Collect patient cost share at time of service.
• Coordinate with physician offices to obtain complete written orders.
• Ensure EMTALA compliance and proper patient identification.
• Support revenue cycle through real-time eligibility checks.

Skills

Registration experience

Customer service

Education

High school diploma or GED

Job description

JOB SUMMARY:

The Admitting Registrar is responsible for timely and accurate patient registration resulting in seamless hand off to clinical departments. The Admitting Registrar interviews the patient, obtains and records applicable demographic and financial information, ensures insurance eligibility, performs pre-cert/authorization, calculates and collects patient portion at time of service.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

• Consistently supports and communicates the Mission, Vision and Values of St. Joseph Medical Center.
• Follows the St. Joseph Medical Center Guidelines related to the Health Insurance Portability and Accountability Act (HIPAA), designed to prevent or detect unauthorized disclosure of Protected Health Information (PHI).
• Promotes a culture of safety for patients and employees through proper identification, proper reporting, documentation and prevention of medical errors in a non-punitive environment.
• Greets patient immediately upon his/her arrival in the registration area, utilizing the appropriate Registration Tracker (ED and non-ED) to date/time stamp patient arrival time, registration begin and end times, delay reasons, and other pertinent registration throughput data elements
• Achieves targeted registration turn-around-times
• Researches scheduled appointment log and/or secures a copy of the physicians order to ensure registration to the correct patient type and status with appropriate routing
• Notifies the appropriate clinical department if the patient has arrived too early or late for their appointment; coordinates the registration process convenient to the physician and/or clinical care area but in compliance with payer authorization and point of service collection requirements (completing the registration process bedside or exam-side if necessary)
• Provides bedside and Medical Screen Out (MSO) registration in the ED; in full compliance with EMTALA rules and regulations
• Research patient visit history to avoid account and/or medical record duplication and ensure compliance with Medicare Payment Window Rules
• Utilizes registration Quick Registration routine as instructed to ensure timely and appropriate delivery of clinical care (ED services and Direct/Urgent/Stat orders)
• Perform and document pre-cert/auth at time of service for all registrations and account status changes (unit to unit and/ou level of care)
• Coordinates activities with physician offices to secure a fully compliant and authenticated written physician order for service; ensures physician compliance with pre-cert/auth and/or referral form requirements so that facility authorization can be obtained without delay
• Assigns accurate and appropriately sequenced payer code/Insurance plans
• Utilizes payer websites and/or eligibility vendor to obtain real time eligibility and benefit detail; printing and/or cut-n-pasting detail to ensure availability for revenue cycle reference
• Completes Medicare Secondary Payer Questionnaire to determine primary payer
• Explains registration forms to the expressed understanding of the patient and obtains the signature of the patient or authorized individual in compliance with state and federal guidelines
• Distributes and Retains patient registration information for Medical Record and financial purposes as per chart distribution guidelines
• Calculates patient cost share and performs point of service collection in accordance with upfront collection policy and procedure
• Communicates with hospital case management as needed to ensure clinical detail is provided to the payer in a timely manner
• Utilize registration system notes to document important information related to the registration process, insurance verification, pre-cert and upfront collection activities
• Meet/exceed performance standards for customer service, registration turn-around-times, productivity and upfront collection goals
• Implements and follows system downtime procedures when necessary
• Other duties as assigned
• Supportive of the compliance program set forth by IASIS and demonstrated by:
• Upholds the SJMC Standards of Conduct and Corporate Compliance.
• Adheres to and helps to enforce all compliance policies relevant to his/her area.
• Assures timely compliance education as requested by the Regional Compliance & Safety Officer and/or through corporate initiatives.
• Sets an example to all staff in their daily activities.

MINIMUM KNOWLEDGE, SKILLS AND ABILITIES REQUIRED:

• 2-3 years of registration or comparable work experience required

• High school diploma or GED required

Houston's oldest hospital is GROWING!

Welcome to St. Joseph Medical Center (SJMC), Houston's first and only downtown hospital delivering world-class care for the last 137 years and looking forward to the next century of exceptional care to Houstonians when they need us most.

Whether it's for a scheduled surgery, the birth of a baby, an unexpected emergency, or an outpatient visit, we have staff available around the clock to provide you access to immediate, quality health care. SJMC has been providing health care services to Greater Houston residents for over 130 years, which should give you great comfort in knowing that we have a great tradition of caring for our community. We strive to meet our patients' expectations and encourage our patients to provide us with feedback on how we can help them have the best experience possible while they're in our care.

Over the last years we have expanded our services to include the Advanced Wound Care Center, Comprehensive Cardiac and Vascular Services, the Women's Center, the St. Joseph Maternal Fetal Medicine Center, and a Weight Loss Surgery Program, just to name a few. As you work with our physicians, nurses, case managers, educators, and other staff, you will be guided through your health care journey, from diagnosis to treatment, with compassion every step of the way.

Diversity, equity, inclusion, and belonging are at the foundation of the care St Joseph Medical Center provides to our community we are privileged to support in all of our employment practices. We do not discriminate on the grounds of race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity, or expression or any other non-job-related characteristic.