PTOT Registration Representative

Job Description

The Registration Specialist is responsible for collection of accurate demographic and insurance information from patients to facilitate a successful patient revenue cycle. Based on the operations of the practice, this position may be responsible for a variety of duties, including collecting and handling payments, providing customer service, answering phones, completing/filing medical records, insurance verification, diagnosis coding, etc. The Registration Specialist is a highly visible position that is always responsible for creating a positive impression with patients and visitors. A Registration Specialist will be on duty during all hours of operation.

Responsibilities

1. Customer Service:

a. Make customer service a top priority and adhere to ExCELS values.

b. Maintain confidentiality at all times.

c. Provide phone coverage during all hours of operation.

d. Answer incoming calls within 3 rings. Identify yourself and department. Allow caller to speak before asking to place them on hold.

e. Eagerly provide assistance to others; voluntarily assist others when his/her own work is finished.

f. Promote a pleasant and positive atmosphere.

g. Listen to, identify and respond quickly and appropriately to customer needs.

h. Deal with conflict in an appropriate and timely manner.

i. Use proper lines of communication to keep others informed or to address problems.

j. Manage site emails.

k. Initiate Patient Liability requests for those patients requesting financial responsibility detail.

l. Coordinate special needs services for patients (translator, transportation, wheelchair).

m. Manage and respond to all department voicemail and Phytel updates.

2. Check In:

a. Verify the patient's identity upon their arrival by requesting, copying and scanning into Epic Documents a form of photo ID. i.e. driver's license.

b. Complete all required fields of registration in Epic.

c. Verify current insurance information by requesting, copying, and scanning into Epic Documents the insurance card(s).

d. Verbally review with the patient, the insurance verification findings during Check In on the initial visit. Note accordingly on the insurance verification form.

e. Obtain consent for treatment and financial agreement signatures on the TCH Consent for Treatment/Financial Agreement form, R14A, to include the ordering physician's name and TCH representative's signature, as witness. Scan both sides of the consent form into Epic Documents or obtain an electronic signature directly into Epic Documents. Review Patient Rights form, obtain signature, unless patient declines. Scan form in Epic Documents.

f. Collect co-pays, when applicable. Post payment in Epic Enterprise Payments.

g. Refer patients to PFS/Financial Assistance, when applicable.

h. Review all hardcopy scripts for required components such as, patient name , DOB, date, time, diagnosis and MD signature.

i. Contact the ordering physician office by phone and re-fax the order back to the MD when any of the above components are missing. Continue to monitor the account until all required information is obtained.

j. Scan all hardcopy referrals/orders.

k. Ensure all diagnosis code(s) are entered in Epic for each appointment scheduled and according to the physician order.

l. Complete a MSPQ for all Medicare patients at the appropriate interval.

m. Have patient complete a medical history form and scan in Epic Documents.

n. Determine which Outcome forms is appropriate for the patient to complete.

o. Review with the patient the necessary outcome form(s) that need to be completed and scan into Epic, Documents.

p. Obtain waivers for non-covered procedures, if applicable, for each visit.

q. Check in procedures apply to all new and returning patients for all sites, with the exception of JSC and Montgomery.

r. JSC check in - frequently new patients will bypass Central Registration and arrive directly in the department. JSC staff will complete the check in process for Central Reg.

s. Montgomery check in - all new and returning patients are "arrived"/checked in by Central Registration.

t. All returning patients are checked in by department level staff for all sites, with the exception of Montgomery.

u. For those patients that prefer not to use the kiosk, they will be checked in by department staff, i.e. JSC and Liberty.

3. Scheduling:

a. Search/find patient in Epic by utilizing the standard three point patient look up process.

b. Verify the patient's date of birth, address and phone number.

c. Update/enter as much demographic information, as feasible, at the time of the call.

d. Verify/obtain the insurance information, to include insurance company name, identification number, phone number, subscriber name, date of birth and employer name.

e. Enter the standard appointment information for new patients, to include the reason for visit, ordering physician's name and ICD10 code.

f. Enter the standard appointment information for return patients, to include the formal ICD10 code, the ordering physician's name and treating clinician(s).

g. Strive to meet goal of scheduling new patient appointments within 48 hrs. of the call, confer with a therapists or manager when necessary.

h. Inform new patients of the proper clothing attire to be worn for the appointment and to bring their insurance card, photo ID and written orders (script) or provide the office fax number for the referring physician to fax the script.

i. Inform the patient copays are expected at the time of service, if applicable.

j. Prior to ending the call reiterate the patient's appointment time and ask if they need directions to the office.

k. All sites, including Montgomery, JSC and Liberty schedule all follow up visits and confer with treating provider, as needed.

l. Access and respond to Account and Referral work queues daily.

m. Follow up on Missing Orders is handled at the department level by contacting the referring physician office.

n. Provide the Physician Referral phone line for individuals that want to schedule therapy and do not have an PCP.

o. Contact PCP office for individuals that want to schedule an appointment but do not have a referral.

p. Contact the patient once the script is received.

q. When no immediate appointment is available, Central Registration will contact the site directly for post op patients that need an appointment with 24 - 48 hours of the call. Department level staff review the schedule for an appropriate time and/or schedule the PO appointment.

r. Provide a printed Patient Itinerary to every patient upon departure from initial visit and/or when appointment schedules change.

s. Schedule all follow up/return visits for all patients, this include all sites.

4. Completion of insurance verification, pre-certification, recertification and referral process prior to patient visit according to the Insurance/Precertification policy guidelines, policy number MI 30.

a. All sites verify insurance benefit information for all new patients, document the findings in the Assigned Referral and transfer information to the Insurance Verification form, excluding Montgomery, JSC and Liberty.

b. Montgomery, JSC and Liberty new patient benefits are verified by the Central Insurance Verification team. Benefit information is transferred from the Assigned Referral to the Insurance Verification form.

c. Monitor insurance benefits for all patients, track visit limitations and obtain additional authorization, as needed.

d. Update the Assigned Referral with all insurance benefit information and benefits status change information, such as, authorization updates, signed plan of care information, number of visits.

e. All sites, verify and document Worker's Compensation benefits

f. Work with TCH PFS and billing as needed to respond to requests.

g. Accurate and timely distribution of patient requests.

h. Respond to correspondence requests.

i. Medical record requests will be processed via Record Reproduction Service (RRS).

5. Chart Prep:

a. Prepare next day's new patient charts, to include, a new patient folder, completed insurance verification form, and consent form. Refer to the Chart Prep policy, number MI 21.

b. Complete Claim Information screens for all new patients, including Central Reg sites; Montgomery, JSC and Liberty.

c. Pull charts.

d. All sites, for every patient visit, review insurance verification forms for any insurance guidelines or limitations, according to policy.

e. Print individual provider schedules.

f. Print and review the DAR (Dept. Appt. Report), according to policy.

g. Retrieve and transmit all documents, such as IPOC, UPOC, PN and DC summaries to the ordering physician office.

h. Record all physician transmittals and monitor the compliance for Medicare/Medicaid accounts requiring a physician signature on the IPOC, UPOC.

i. Monitor each Medicare account for signed POCs, follow up via fax and phone to ordering physician when signed POC is not returned within the appropriate amount of time.

j. Scan all hardcopy signed POCs in Epic, update the insurance verification and the assigned referral, accordingly.

k. Scan all documents in Epic, to include, medical history form, outcome forms, exercise sheets, any hardcopy documentation that is not electronically in Epic.

6. End of Day Close:

a. Print daily Revenue Usage Report.

b. Reconcile Rev Usage report to the DAR to ensure all patients/charges are accounted for each business day.

c. Correct any charge entry discrepancies through Account Maintenance and/or communicate with the treating clinician any discrepancies that need correction.

d. Print daily Payment Summary Report (PSR).

e. Reconcile PSR, deposit ticket and credit card receipts.

f. Complete a Daily Deposit Reconciliation form for each business day.

g. Retain copies of all supporting documentation in the daily packet folder, according to policy number MI 22.

h. Bank trips will be made within 24 hours of business day for all sites.

i. Montgomery and Liberty will make daily drop box deposit and JSC deliver the daily deposit to the Cashier's office on Level C of the main hospital by 8:00am the next business day.

j. Retain a copy of the bank date stamped deposit ticket in the daily packet folder.

k. Timely and accurate filing and distribution.

7. Other duties as assigned by supervisor or authoritative manager to include flexibility of routine hours to adequately maintain registration coverage for the department hours of operations, and communicating office supply needs to appropriate party.

Qualifications

KNOWLEDGE AND SKILLS:

Please describe any specialized knowledge or skills, which are REQUIRED to perform the position duties. Do not personalize the job description, credentials, or knowledge and skills based on the current associate. List any special education required for this position.

EDUCATION: H.S. Diploma/GED

YEARS OF EXPERIENCE: No formal experience required. Six months to one year medical office experience preferred.

REQUIRED SKILLS AND KNOWLEDGE: Basic clerical skills and data entry knowledge required.

1. Preferred knowledge of Epic computer system

2. Preferred knowledge of Ohio/Kentucky insurance plans.

3. Preferred knowledge of Ohio/Kentucky insurance verification processes for various insurance plans.

4. Preferred post high school experience related to medical office environment.

LICENSES & CERTIFICATIONS:

N/A

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