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The Christ Hospital in Cincinnati is seeking a revenue cycle professional to obtain and verify patient demographic, financial, and insurance information to support high-quality patient care and optimal reimbursement. The role involves scanning documents into OnBase, verifying EMTALA-related details and notifying clinical staff of critical conditions.
Responsibilities include analyzing accounts, understanding insurance plans, completing MSPQ questionnaires, coordinating with Financial Counselors,
Obtain and verify appropriate personal, demographic and financial information for the purposes of ensuring (1) Quality patient care through proper patient identification and (2) maximal reimbursement for all billable clinical services rendered. (3) Scanning the appropriate identification documents into OnBase. Obtain EMTALA notification signature. (4) Notify clinical staff when patients present with critical condition. (5) Once verified places appropriate insurance information on account.
Analyze patient accounts; evaluate financial data for establishment of current accounts and documents comments to reflect actions taken regarding accounts to maximize reimbursement. Maintain knowledge of current HMO/PPO/Medicaid/Medicare/commercial insurance regulations and requirements. Requires working knowledge of Insurance Plans the Christ Hospital participates in. Determines all insurance coverage's as primary, secondary, tertiary, etc. Completes required MSPQ questionnaires for all appropriate patients. Obtains and documents clinical referrals from other providers. Coordinates patients in need of financial assistance to pay for present and/or future services to appropriate Financial Counselor. Collects and deposits according to specified protocols, all required and mandatory insurance co-payments.
Processes Emergency and Obstetrics by notifying appropriate staff. Answers and directs incoming calls from Physician's office staff, ancillary departments and other facilities. Answers inquiries concerning hospital policies.
Obtains signatures for the visit for all revenue cycle documentation. Prepares charts, collected forms and photocopies (insurance cards) and documentation. Distribute, witness by signature and collect patient advanced directive forms/information; referring patients to appropriate personnel to address specific questions as indicated. Provides patients with information about their rights and responsibilities and all other duties as assigned.
Interviews patients and obtains, verifies and enters into database complete and accurate demographic and financial information. Assesses and updates information as it relates to each encounter. Determines financial plan and coverage priority. (Data collected directly impacts financial and clinical systems,)
Must maintain facility established productivity standards and Patient Accounts Quality Guidelines (i.e. 100% accuracy of 95% of all registrations).
Must communicate effectively and meet or exceed established customer service goals.
Provides education and training/mentoring for other staff members. Attends department meetings and reviews procedural & process changes per facility specific guidelines.
Please describe any specialized knowledge or skills, which are REQUIRED to perform the position duties. Do not personalize the job description, credentials, or knowledge and skills based on the current associate. List any special education required for this position.
High School Diploma, Associates Degree preferred or equivalent combination education and experience.
One to three years experience in Registration, Billing, Customer Service, or Managed Care Organization work environment. Must have/gain knowledge of the Hospital Medical Staff rules and infection control policies to be effective in this position.
Analytical skills required to make decisions based on the facility and clinical situation at hand.
Epic, Passport, OnBase, Microsoft Office products and Midas.
Knowledge of health insurance coverage, requirements.
Must understand medical terminology and acuity levels.
Annual Registration Competency Review with 95% or greater score obtained.
Yearly STAT testing completed.