Outpatient Registrar

Penn Medicine; Doylestown (Bucks County); On-site; USD 32,000 - 45,000; Full time

Job summary

Penn Medicine is seeking an outpatient pre-registration specialist to join our team. You will ensure accurate patient demographics, verify insurance eligibility, and secure necessary authorizations to support timely care and proper reimbursement.

You will enter physician orders, verify medical necessity, and manage the patient financial responsibility while directing patients to available financial assistance as needed.

Qualifications

• Pre-registration and registration of outpatient accounts to ensure accuracy and reimbursement.
• Verify patient insurance eligibility and benefits, identifying plan IDs and contracts.
• Secure and/or verify required authorizations to prevent denials.
• Enter physician orders into the ADM/ITS systems and check medical necessity.
• Identify and collect patient financial responsibility and refer to financial assistance as needed.

Responsibilities

• Pre-Register / Register Patients. Positively identify the correct medical record and visit account; enter complete demographic information; document visit reasons and ICD codes.
• Verify insurance eligibility and benefits; determine correct plan identification; confirm resources per department protocols; screen for service capitation; complete Medicare Secondary Payer questions.
• Secure and/or verify authorizations required for services to avoid later denial by the carrier; monitor until authorization is complete.
• Enter physician orders into ADM and ITS; check medical necessity and ABN processing; contact physicians for updated scripts as needed.
• Identify patient financial responsibility; collect amounts; identify need for financial assistance and direct to resources.

Education

H.S. Diploma/GED (Required)

Job description

Description

Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines.

Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work?

Summary:

• Complete accurate pre-registration or registration for outpatient accounts, maintaining standards set for accuracy, positive patient experience and successful reimbursement for services.

Responsibilities:

• 1. Pre-Register / Register Patients .Positively identify correct medical record and correct visit account. .Enter/ update complete demographic information. .Enter all physician-documented reasons for visit and ICD codes. 2. Verify patient’s insurance eligibility and benefits .Determine correct insurance plan identification, with potentially multiple and differing contracts. .Verify eligibility and benefits using available resources and according to department protocols. .Screen for service capitation. .Complete Medicare Secondary Payer questions as required. .Document accounts with payer data .Consistently resolve account errors in individual work queue within prescribed time frame; maintain individual/group RQA quality score at or above minimum standard. 3. Secure and/or verify authorization for service .Verify and/or secure specific related authorization requirement necessary to prevent later denial of charges by the carrier. .Monitor patient account until authorization has been completed. 4. Enter physician orders accurately .Enter physician orders into the ADM and ITS (Pre Natal registration only) Order Management modules, as required. .Check Medical Necessity and process ABN’s (Advanced Beneficiary Notices). .Proactively contact physician offices for updated scripts when necessary. 5. Identify and Collect patient’s financial responsibility .Collect patient financial responsibility. Calculate patient estimated cost as applicable. .Identify need for financial assistance and direct patients to appropriate resource.

Credentials:

Education or Equivalent Experience:

• H.S. Diploma/GED (Required)

We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program that includes one of the finest prepaid tuition assistance programs in the region. Penn Medicine employees are actively engaged and committed to our mission. Together we will continue to make medical advances that help people live longer, healthier lives.

Live Your Life's Work

We are an Equal Opportunity employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law.

REQNUMBER: 347360