Patient Management Clerical Associate

Patient Management Clerical Associate

Requirements

• High school diploma or equivalent.
• One to two years work experience in hospital healthcare insurance, medical records, billing or related area desirable.
• Working knowledge of medical terminology desired.
• A strong commitment to the DMC customer service standards.
• On the job training or related previous experience to acquire skills in screening and preparing patients for exams. Some college preferred.
• Six to twelve months of related computer/information management experience required.

Responsibilities

• Registers and schedules patients for health services ensuring appropriateness of setting for services provided.
• Obtains insurance, medical and/or demographic data to admit or pre-admit patients to the health facility.
• Verifies insurance coverage and benefit levels with various third party payers.
• Assists patients without medical insurance coverage in completing medical assistance applications and/or making payment arrangements.
• Collects cash for deductibles and coinsurances, per insurer guidelines.
• Participates in bed management activities as defined in operating unit policies and procedures.
• Functions as liaison between patient and health facility by answering patients questions regarding health facility policies and billing requirements.
• Assists patients in completing necessary forms and obtains patient signature as dictated by facility policies and procedures.
• Collects referrals and authorizations; facilitates securing referrals and authorizations from referring providers as necessary.
• Performs pre-registration and pre-admission activities via telephone prior to service.
• Greets or contacts patient; collects and verifies all necessary demographic insurance and related data.
• Schedules appointments, generates appointment notices, reschedules and posts cancellations; determines appropriate service settings in accordance with established policies and procedures; and resolves scheduling issues in conjunction with appropriate providers and ancillary departments.
• Verifies insurance coverage and benefit levels; secures authorizations and referrals; assesses patient liability amounts.
• Provides financial counseling services to assist patients in identifying and obtaining alternate payment sources.
• Reviews, monitors, and reconciles collected demographic and insurance data in order to ensure accurate bill production.
• Ensures compliance with third party payer requirements.
• Reconciles and corrects rejected erroneous data transactions as displayed on Transmission, Control and Errors (TCE) reports.
• Accesses computerized system to enter and/or update electronic systems as needed and to answer patients, stakeholders and other pertinent parties inquiries.
• Maintains patient service records and performs related duties as requested.
• Participates in bed management as defined by operating unit policies and procedures.
• Communicates clinical, financial, and administrative information.
• Performs other duties as assigned.
• Assists nursing and technical staff in screening patients and performs a variety of moderately to highly complex patient registration duties.
• Interacts with technologist and radiology nursing staff; interacts with customers/stakeholders to provide/distribute appropriate exam results in a timely and accurate manner; maintains patient charts and films as appropriate.

Preferred Qualifications

• One to two years work experience in hospital healthcare insurance, medical records, billing or related area desirable.
• Working knowledge of medical terminology desired.
• On the job training or related previous experience to acquire skills in screening and preparing patients for exams. Some college preferred.