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Pre-Registration Manager in Sylva, NC at Harris Regional Hospital

Date Posted: 3/12/2019

Job Snapshot

Job Description

Harris Regional Hospital

The Pre-Registration Manager is responsible for the day-to-day operation and management of Pre-Registration associates and other support staff within the assigned area(s) which may also include Scheduling, Insurance Verification, and Orders processing staff. Coordinates processes and communicates with physician offices, clinical and ancillary departments and other service areas to promote timely and accurate registration process. Assures through assigned staff, the accurate and efficient pre-registration of all schedule patients for diagnostic testing, ambulatory surgery, outpatient procedures and in-house admissions, while maintaining excellent customer service skills to physician’s offices, patients, co-workers and hospital employees. Required elements include verification of insurance benefits, pre-authorization/pre-certification when necessary, collection of applicable co-pays and/or deductibles, and assistance to patients and family members with resolution of all their financial needs. Staffs department as part of the pre-access team, responsible for call-in staffing, bringing issues to management for review and maintenance of time card management and approval.  

Job Functions
• Responsible for making excellent first impressions with patients and families. Ensures that patients, their families, visitors, customers, and staff members are treated with kindness and respect. 
• Responsible for managing Pre-Registration area including as assigned; Scheduling, Insurance Verification, Pre-registration and/or Order processing staff to ensure quality registration, billing and collection services in accordance with applicable policies and procedures. 
• Protects the financial standing of DLP Harris Regional Hospital by appropriately placing financial responsibilities and effectively managing department operations, performance planning and review and quality control.
• Responsible for personal development to ensure current knowledge of Access Management.
• Provides effective management to associates in area(s) of responsibility, including orientation, scheduling of work, associate training and development, performance planning and review, and quality control
• Collaborates regularly with ancillary departments to ensure appropriate coordination of patient information and timely flow of services. 
• Participates in the development, implementation and administration of area policies and procedures. 
• Ensures through appropriate staff, the documentation, communication and understanding of same. 
• Demonstrates behaviors consistent with stated Mission and Core Values of the facility. 
• Adheres to the standards and policies of the Corporate Compliance Program, including the duty to comply with applicable laws and regulations, and reporting to designated Director (or employer hotline) any suspected unethical, fraudulent, or unlawful acts or practices. 
• Is responsible for performing all other duties as assigned. Indicates non-essential job function

KNOWLEDGE AND SKILL REQUIREMENTS:     
• Demonstrates strong working knowledge of processes related to area of assignment which may include hospital patient registration process, work assignment structure, account documentation, system operation, regulations and related communication protocol; general knowledge of third party payor requirements as they apply to hospital patient admissions; working knowledge of medical terminology per area of assignment.  Accepts responsibility; possesses integrity, imagination, and initiative as evidenced by self-improvement; exhibits kindness, compassion, understanding, integrity, interest and respect for people as individuals; uses discretion when discussing personnel/patient-related issues that are confidential in nature; and is responsive to the ever-changing departmental matrix needs and acts accordingly.
• Requires strong analytical and organizational skills to prepare and maintain various documentation and reports. 
• Manage activities of staff and ensure compliance with hospital policies, procedures and customer service needs in the patient registration department. 
• Demonstrated communication skills, including ability to give and follow verbal directions, and ability to promote positive interpersonal relationships. 
• Requires skills to work in a fast paced, multitasked, deadline oriented office environment, with constant communication with patients, families and other hospital departments. Requires leadership, group cohesion and communication skills promoting teamwork and group achievement. 

PAU Elements
• Obtains necessary data elements required to coordinate patient’s pre-arrival process
• Responsible for proper patient and insurance identification.  This includes the appropriate selection of patients / MRNs in the system. Enters patient’s correct information into HIS system accurately and within strict adherence of HIPAA guidelines.
• Obtains and validates patient demographic, insurance, and required clinical information.  
• Completes insurance verification and benefit eligibility checks with complete documentation in HIS of findings including required 16 components of insurance verification, payment estimation amount, any pertinent information regarding patient / guarantor conversation, and applicable names (insurance representative, utilization review rep), location, time, etc. 
• Ability to calculate figures and amounts such as discounts and percentages.
• Ability to work with technology necessary to complete job effectively. This includes, but is not limited to; phone technology, HIS system, insurance verification / eligibility tools, patient liability estimation tools, and scanning technology.
• Obtain and maintain knowledge of numerous forms requiring signature and/or information to be given to patient on various subjects such as Advanced Directives, Consents, Privacy Notices, Patient Rights, etc…
• Create accurate estimate for patient’s scheduled procedure(s) by using payment estimation tool, while being knowledgeable of patients’ copayment, deductible, coinsurance, out of pocket and/or exclusions/riders. 
• Actively collects and posts patient liabilities from patients, as appropriate, in a polite and courteous manner by using generated estimate or manual calculation of out of pocket obligation.
• Responsible for obtaining initial precertification / authorization information and proper patient type assignments. Obtaining prior authorization, referral or precertification for specific procedure(s) being performed, at least one day prior to the patients scheduled date of service and documents account(s) / systems accordingly. 
• Validates / obtains physician orders for service, as necessary.
• Counsels patients/patient’s family regarding insurance programs, financial responsibilities and hospital/federal regulations via phone conversation. 
• Coordinates interaction with physician office to provide demographic and payor information as needed.

Adheres to and follows the principles of the facilities customer relations program / HR requirements
• Creates a positive impression through effective use of telephone skills such as answering the phone by the third ring, identification of self and department, listening attentively, personalizing the conversation and verifying information.
• Creates a supportive climate for customers by allowing customers to express themselves, addressing their concerns as being real and encouraging two-way communications.
• Answers incoming patient calls routed into Pre-Registration department designated line and properly pre-registering patient for upcoming procedure.
• Participates in all educational activities, and demonstrates personal responsibility for job performance.   
• Organizes work/resources to accomplish objectives and meet deadlines.  
• Maintains stable performance under pressure or opposition.  Handles stress in ways to maintain relationships with patients, customers and co-workers.

Job Requirements

Education:
• Associate’s degree preferred: or four to six years related experience in patient access arena with a minimum of two years in a lead roll; or equivalent combination of education and experience. Previous leadership skills preferred with the ability to demonstrate a strong, positive leadership role. 

Experience:
• Experience is required as follows in one or more of the following areas: Minimum of two year related experience; prior medical registration and medical insurance experience a plus. Demonstrates strong working knowledge of processes related to areas of assignment, including work assignment structure, account documentation, system operations, regulations and related communication protocols and medical terminology. Minimum one year management experience. Demonstrates skills related to patient concerns and problem solving including relations with other departments and service recovery. Excellent phone etiquette and customer service skills required. Demonstrated communication skills, including ability to give and follow verbal directions, and ability to promote positive interpersonal relationships. Requires skills to work in a fast paced, multitasked, deadline oriented office environment, with constant communication with physicians, physician offices and other hospital departments. Identifies and understands issues and problems.  Examines data and draws logical conclusions demonstrating the ability to apply moderate levels of critical thinking and understanding.  Must demonstrate ability to formulate action plans that are consistent with available facts, constraints and probable consequences and chooses an appropriate course of action or solution. 

Equal opportunity and affirmative action employers and are looking for diversity in candidates for employment: Minority/Female/Disabled/Protected Veteran