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Patient Care Coordinator Associate
2 months ago
As an Associate Patient Care Coordinator at UnitedHealth Group, you will play a vital role in ensuring that our patients receive the highest quality of care. Your primary responsibility will be to maintain up-to-date knowledge of specific registration requirements for all areas, including but not limited to: Main Admitting, OP Registration, ED Registration, Maternity, and Rehabilitation units.
Key Responsibilities- Maintains up-to-date knowledge of specific registration requirements for all areas.
- Ensures complete, accurate and timely entry of demographic information into the ADT system at the time of registration.
- Properly identifies the patient to ensure medical record numbers are not duplicated.
- Responsible for reviewing 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 documenting completion within the hospital's information system for regulatory compliance and audit purposes.
- Collects and enters required data into the ADT system with emphasis on accuracy of demographic and financial information in order to ensure appropriate reimbursement.
- Carefully reviews all information entered in ADT on pre-registered accounts.
- Verifies all information with patient at time of registration; corrects any errors identified.
- Identifies all forms requiring patient/guarantor signature and obtains signatures.
- Ensures all required documents are scanned into the appropriate system(s).
- Identifies all appropriate printed material hand-outs for the patient and provides them to the patient/guarantor (Patient Rights and Responsibilities, HIPAA Privacy Act notification, Advance Directive, etc.).
- Follows '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.
- Assesses self-pay patients for presumptive eligibility and when appropriate initiates the process.
- Monitors and addresses tasks associated with the Mede/Analytics PAI tool.
- Follows approved scripting, verifies 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 documents insurance verification information in the ADT system, identifying deductibles, copayments, coinsurance, and policy limitations.
- Obtains referral, authorization and pre-certification information; documents this information in the ADT system and submits notices of admission when necessary.
- Verifies medical necessity check has been completed for outpatient services. If not completed and only when appropriate, uses technology tool to complete medical necessity check and/or notifies patient that an ABN will need to be signed.
- Identifies payer requirements for medical necessity.
- Verifies patient liabilities with payers, calculates patient's payment, and requests payment at the time of registration.
- Identifies any outstanding balance due from previous visits, notifies patient and requests patient payment.
- Sets up payment plans for patients who cannot pay their entire current copayment and/or past balance in one payment.
- Thoroughly and accurately documents the conversation with the patient regarding financial liabilities and agreement to pay.
- When collecting patient payments, follows department policy and procedure regarding applying payment to the patient's account and providing a receipt for payment.
- Clarifies division of financial responsibility if payment for services is split between a medical group and an insurance company. Ensures this information is clearly documented in the ADT system.
- When necessary, escalates accounts to appropriate Patient Registration leadership staff, based on outcomes of the verification process and patient's ability to pay.
UnitedHealth Group is a global organization that delivers care, aided by technology to help millions of people live healthier lives. We believe everyone – of every race, gender, sexuality, age, location, and income – deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes – an enterprise priority reflected in our mission.
What We Offer- Competitive base pay
- A full and comprehensive benefit program
- Performance rewards
- A management team who demonstrates their commitment to your success
- Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
- Medical Plan options along with participation in a Health Spending Account or a Health Saving account
- Dental, Vision, Life & AD&D Insurance along with Short-term disability and Long-Term Disability coverage
- 401(k) Savings Plan, Employee Stock Purchase Plan
- Education Reimbursement
- Employee Discounts
- Employee Assistance Program
- Employee Referral Bonus Program
- Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
