Duration: 3-month contract with possible extension
Location: Chesterfield, MO 63017
Principle Accountabilities:
Acts as the primary patient liaison upon arrival to the Emergency Department, initiating patient flow and performing all functions necessary to comply with managed care contracts and CMS regulations.
Conducts face-to-face interviews with patients and/or family members in a fast-paced, high-acuity environment to achieve successful clinical outcomes and maintain charge integrity in a clinically driven revenue cycle.
Processes patient accounts in accordance with departmental and institutional policies and procedures.
Responsible for accurate registration of patient demographics and insurance, assures the validity of incoming data, corrects information as needed, and processes the registration including explaining and obtaining patient signatures on the Consent for Admission/Treatment, Release of Information/Assignment of Benefits and Financial Responsibility, and completing Medicare Secondary Payer (MSP) questionnaire.
Collects proper consent for Missouri Health Connection to share PHI data. Assesses and interprets Medical Necessity guidelines with providers to prevent denials and to comply with CMS regulations to formally notify the patient of their rights and limitations via the appropriate format.
Documents of actions taken, answers inquiries involving patient registrations, and research problems to assure payment. Scans documents to the patient's medical record via Cerner Imaging Functions.
Verifies insurance eligibility and benefits to notify patients of expected financial responsibility and collects at time of service. Provides financial counseling concerning payment options and financial assistance. Reviews provider orders for accuracy and completeness and follows up with physician offices as needed.
Demonstrates sensitivity and professionalism when engaging with patients and families under emergency and emotionally distressed circumstances.
Actively collaborates with ED clinical staff — including nurses, physicians, technicians, and care coordinators — to facilitate seamless patient flow, communicate registration status, and ensure clinical teams have the information needed to deliver timely care.
Proactively communicates with clinical staff regarding patient arrival, registration delays, insurance or authorization issues, and any factors that may impact the patient's care experience.
Approaches all interactions with clinical partners in a spirit of teamwork, mutual respect, and shared accountability for the patient experience.
Assures the integrity of critical system data elements. Completes assignments in the prescribed time periods with efficiency and attention to detail.
Answers patient and/or third-party inquiries regarding patient accounts, insurance eligibility and coverage questions, and/or institution or department policies and procedures.
Adheres to Patient Access and client's policies, hospital/physician billing practices, third-party requirements, and HIPAA regulations.
Obtains patient signatures on the Patient Representative, Motor Vehicle Accident, and Out of Network forms.
Teach new employees and other staff members procedures. Works efficiently with other staff members to accomplish work and departmental projects.
Provides information and assistance to physicians regarding billing and pre-certification procedures.
Works to resolve patient complaints and workflow issues before escalating to the Lead or Supervisor.
