Patient Care Coordinator

2 weeks ago


Phoenix, Arizona, United States UnitedHealth Group Full time
Job Summary

We are seeking a highly skilled and detail-oriented Associate Patient Care Coordinator to join our team. As a key member of our Patient Registration department, you will play a critical role in ensuring the smooth and efficient registration process for our patients.

Key Responsibilities
  • Maintain up-to-date knowledge of specific registration requirements for all areas, including main admitting, OP registration, ED registration, maternity, and rehabilitation units.
  • Ensure complete, accurate, and timely entry of demographic information into the ADT system at the time of registration.
  • Properly identify patients to ensure medical record numbers are not duplicated.
  • Review assigned accounts to ensure accuracy and required documentation is obtained and complete.
  • Meet CMS billing requirements for the completion of the MSP, issuance of the Important Message from Medicare, issuance of the Observation Notice, and other requirements, as applicable, and document completion within the hospital's information system for regulatory compliance and audit purposes.
  • Collect and enter required data into the ADT system with emphasis on accuracy of demographic and financial information to ensure appropriate reimbursement.
  • Review all information entered in ADT on pre-registered accounts.
  • Verify all information with patients at the time of registration and correct any errors identified.
  • Identify all forms requiring patient/guarantor signature and obtain signatures.
  • Ensure all required documents are scanned into the appropriate system(s).
  • Identify all appropriate printed material hand-outs for patients and provide them to patients/guarantors (Patient Rights and Responsibilities, HIPAA Privacy Act notification, Advance Directive, etc.).
  • Follow 'downtime' procedures by manually entering patient information, identifying patient's MRN in the MPI database, assigning a financial number, and accurately entering all information when the ADT system is live.
  • Assess self-pay patients for presumptive eligibility and, when appropriate, initiate the process.
  • Monitor and address tasks associated with the Mede/Analytics PAI tool.
  • Follow approved scripting, verify insurance benefits on all patients registered daily by using electronic verification systems or by contacting payers directly to determine the level of insurance coverage.
  • Thoroughly and accurately document insurance verification information in the ADT system, identifying deductibles, copayments, coinsurance, and policy limitations.
  • Obtain referral, authorization, and pre-certification information, document this information in the ADT system, and submit notices of admission when necessary.
  • Verify medical necessity check has been completed for outpatient services. If not completed and only when appropriate, use technology tools to complete medical necessity checks and/or notify patients that an ABN will need to be signed.
  • Identify payer requirements for medical necessity.
  • Verify patient liabilities with payers, calculate patient payments, and request payment at the time of registration.
  • Identify any outstanding balance due from previous visits, notify patients, and request patient payment.
  • Set up payment plans for patients who cannot pay their entire current copayment and/or past balance in one payment.
  • Thoroughly and accurately document conversations with patients regarding financial liabilities and agreements to pay.
  • When collecting patient payments, follow department policy and procedure regarding applying payment to the patient's account and providing a receipt for payment.
  • Clarify division of financial responsibility if payment for services is split between a medical group and an insurance company. Ensure this information is clearly documented in the ADT system.
  • When necessary, escalate accounts to appropriate Patient Registration leadership staff, based on outcomes of the verification process and patient's ability to pay.
Why Work for UnitedHealth Group?

At UnitedHealth Group, we offer a comprehensive benefits package, competitive pay, and opportunities for professional growth and development. Our team is dedicated to delivering high-quality care and services to our patients, and we are committed to creating a positive and inclusive work environment.

Requirements
  • High School Diploma/GED (or higher)
  • 1+ years of experience in customer service
  • Beginner level of proficiency working with computers/data entry
Preferred Qualifications
  • 1+ years of experience working in a hospital Patient Registration department, physician office setting, healthcare insurance company, revenue cycle vendor, and/or other revenue cycle-related roles
  • General understanding of insurance policies and procedures
  • Working knowledge of medical terminology
  • Able to perform basic mathematics for payment calculation
Soft Skills
  • Excellent interpersonal, communication, and customer service skills


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