I have over 15 years experience in a customer focused environment with the ever changing customer needs as the driving force to produce award winning customer service.
• Coordinates all aspects of securing accounts to include pre-registration, eligibility and benefits, referral coordination, and expressing financial expectations using on-line systems, telephonic verification, and faxing to update and verify patient demographic and payer information.
• Documents and updates all registration and financial data in the Hospital Information System. Responsible for the correct identification and selection of appropriate insurance plan codes. Performs follow-up functions to correct deficiencies in data collection utilizing available systems such as ONTRAC, the Hospital Information System and ancillary systems as available.
• Obtains complete demographic and billing data collection from non-English speaking patients by arranging for Interpreting Services or other assistance as may be necessary to facilitate the completion of registration and financial clearance process.
• Responds to telephone inquiries related to registration practices, billing and insurance requirements and general services provided in different programs and locations. Assumes responsibility for routing calls to appropriate individuals and departments.
• Develops strategies to be effective and remain professional while coping with difficult customers and situations. Maintain awareness of cultural, socio-economic, individual, religious, gender and other diversity uniqueness in patient's communication.
• Establishes communication with patients if necessary to inform them to reschedule appointments. Notifies the appropriate Ambulatory Care practice/physician's office about cancellations and reschedule appointments based on patient's medical needs and physician decision for patients who are not eligible for services or not authorized.
• Advises supervisor/manager of problems and potential problems as soon as possible within 24 hours. Takes ownership of all appointments assigned. Personal actions demonstrate accountability for the outcomes of the unit.
• Works closely with supervisors, practice managers, physicians, and all members of the health system to resolve problems or issues related to patient's registration, financial issues or third party payer inquiries.
• Follows work prioritization standards as established, using standard tools (ONTRAC worklists, reports, etc.) to complete work in the most effective manner established, and enter appropriate account status codes. Documents work activity clearly, concisely, and completely all in a timely manner according to established documentation standards.
• Assists in training of new and additional personnel and provides for coverage as needed.
• Applies skills, knowledge, abilities, and utilizes reporting tools in order to meet performance and productivity standards as defined by workloads.
• Adheres to department Quality Review process. Performs extensive follow-up as accounts are processed to ensure timely and accurate completion. Adheres to department productivity expectations as outlined.
• Performs other duties as assigned.
Responsible for the coordination of appointments and support services for departments/physicians. Interface with insurance companies and other payors on proir authorization and referral requests, abstract charts and assign CPT, ICD-9 and HCPCS codes for purposes of obtaining prior authorization. Assist billing personnel with preparation of denials and submitting appeals for payment. Assist in resolving patient problems, concerns and complaints; serve as patient advocate and liaison, interface with patients, families, staff and department/physicians. Ensure adherence to Hospitals and department policies and procedures. Patient care assignment may include neonate, pediatric, adolescent, adult and geriatric age groups
Perform a variety of customer service duties; provide information and assistance to internal and external customers; schedule appointments, verify medical coverage; perform basic cashier duties; serve as first contact for incoming customers within assigned ambulatory setting; ascertain customer's needs and direct appropriately. Ensure adherence to Hospitals and departmental policies and procedures. No patient care assignment.
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