Admitting Representative III

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Date: Mar 27, 2019

Location: Irvine, CA, US

Company: Hoag Memorial Hospital Presbyterian

Job Description:

The Admitting Rep III requires the ability to provide registration for patients arriving for service, collect required deposits and ensure appropriate authorization is in place for services being provided. The coordinator must ask for all necessary data and enter this information correctly into Affinity to provide an accurate patient record at time of registration. Able to assist patients with obtaining medical records in accordance with hospital policy. The Admitting Rep II obtains authorizations as required, enters orders for lab/radiology including arriving patients for radiology procedures. Performs quality control functions on all accounts and provides/completes QA spreadsheet for error tracking. Aids in training inexperienced staff. Performs clerical functions to meet identified department needs.

Projects an image of professionalism in communication, appearance and conduct. Supports the Hospital and Business Office missions. Participates in the continuous quality improvement process. Maintains a working knowledge of departmental procedures. Must be able to perform bed board functions, may be responsible for working as a coordinator in conjunction with house supervisor in the assignment of patient care beds within the hospital. Supplies coverage for clerical areas as needed. Trains new staff as required. Able to trouble shoot, problem solve with occasional supervision.


Essential Functions:

  • Acts as a liaison between hospital and patient/family regarding financial matters while patient is in-house.
  • Counsels and advises the patient concerning financial alternatives and program options.
  • Completes patient registrations, obtains required signatures and validates correctness of information.
  • Develops knowledge of insurance and government programs and the requirements for all insurances.
  • Ensures eligibility and authorization for insurance is in place upon registration.
  • Identifies and collects co-payments as appropriate at the time of service.
  • Meets daily productivity expectations in accordance with department standard.
  • Offers guidance, assistance and direction to less experienced personnel.
  • Provides direction, upon request from patient, regarding check-in processes for services.
  • Provides other departments with required paperwork in a timely manner.
  • Utilizes established protocol for proper look-up of patients being registered for services to ensure duplicate medical record numbers are not created.
  • Verifies insurance after the doctor has seen the patient.
  • Ensure that quality patient care is delivered to all patients on a 24-hour basis, and the unit is maintained in accordance with professional and regulatory standards and the philosophy and goals of Hoag.
  • Always willing to go above and beyond to assist our patient in the healthcare journey.
  • Collects deposits/payments via credit card, cash or check for the patient's portion of their incurring charges.
  • Processes/records daily payments in accordance with department procedures.
  • Asks appropriate MSI questions to patients who inquire about eligibility.
  • Assists Patient Access staff with questions regarding financial class, benefits, and authorization requirements.
  • Assists patients with questions regarding benefits.
  • Communicates all Financial Class changes to Case Managers.
  • Communicates error problems to manager and/or QA person.
  • Contacts Financial Counselor regarding any amounts owed by the patient.
  • Contacts insurance carrier to determine eligibility/benefits.  Contacts IPA to verify authorization for admission.
  • Corrects errors to ensure correct billing and document changes in system.
  • Educates physician staff regarding Hospital requirements.
  • Enters all information into system.
  • Follows up on IPA/PCP changes and payer changes during IP stay.
  • Follows up with IPA and payers on missing information or late call backs.
  • Gathers all pertinent documents needed for verification.
  • Leaves message for Case Manager regarding patient admission and need for clinical or transfers insurance company to case manager's line to request needed information.
  • Obtains authorization and/or tracking numbers.
  • Updates changes in demographic financial, information in notes.
  • Updates patient demographic and financial information in system.
  • Verifies all Radiology accounts (as specified) prior to date of service. 
  • Verifies all SDS accounts prior to the date of survey.
  • Enters lab/radiology orders in respective systems as appropriate.
  • Verifies all orders are accurate and have all documentation needed for proper billing.
  • Coordinates denial notices with case management and secures payment for non covered services.
  • Educates patients on hospital Charity Care/Patient Assistance program. Obtains completed financial statements from patients applying for Charity Care.
  • Keeps manager informed when problems or delays occur in department.
  • Maintains patient accounts in order, with all documents filed during the patient's hospital stay. Obtains missing signatures and information from patient or family (social security number, address, etc.).
  • Monitors accounts of patients with continued stay to ensure coverage/benefits in force. Checks for Medicare days available. Informs patient/family if benefit maximum approaching. Asks for deposit or screens patient for programs to cover remainder of stay. Runs eligibility and verifies benefits as needed.
  • Possess knowledge of payer contracts.
  • Processes MSI applications. Obtains missing information. Educates patients on MSI program.
  • Updates accounts when corrected insurance information is obtained to ensure appropriate billing data. Communicates changes to case management, insurance verification, Chartmaxx i.e., face sheet updates.
  • Works daily private pay in-house patients report. Contacts patient/family for insurance information or deposit if cash patient.
  • This position may also function as a bed board coordinator with the following functions:
  • Coordinates in conjunction with the patient flow coordinator and/or house supervisor the assignment of patient care beds within the hospital.
  • Responsible for all bed assignment duties, including, but not limited to, bed assignments for all inpatient admissions (elective, direct, emergent), inter- and intra-hospital transfer patients/bed assignments, and prioritization of patient placement per hospital policy and infection control requirements.
  • Maintains census per department policy and admission criteria.
  • Works in collaboration with multiple departments within the hospital and attends regularly scheduled bed management meetings with hospital staff to identify and communicate bed utilization issues.
  • Ensures patient through put is not delayed due to registration or insurance issues.
  • Demonstrates proficiency in all Patient Access Areas.
  • Performs other duties as assigned.



Job Requirements:

  • High School diploma.
  • One-year general office experience and / or customer service experience, preferably in a medical setting with basic business skills, i.e., typing 35+ wpm and computer experience.
  • Some college coursework completed or minimum of 6 months prior experience in Patient Access, health administration or related field.
  • Prior experience with an automated attendant software (i.e. Amelior).
  • Cash handling experience, Financial counseling.
  • High level of computer keyboarding skills for data input.
  • Able to communicate clearly in English, both written and oral.
  • Strong attention to detail.
  • Demonstrated analytical and critical thinking abilities with pro-active decision making and negotiation skills.
  • Ability to manage multiple tasks simultaneously.
  • Ability to establish and maintain collaborative and effective working relationships.
  • Strong customer service skills.


Job Preferences:

  • A minimum of two (2) years’ experience in bed management.

Nearest Major Market: Irvine California
Nearest Secondary Market: Los Angeles

Job Segment: Medical, Clerical, Radiology, Law, Customer Service Representative, Healthcare, Administrative, Legal, Customer Service

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