Patient Registration, Auths, & Scheduling Rep (PRN)

Description

PURPOSE STATEMENT

Provide flexible, cross-functional support to Central Scheduling, Central Authorizations, and Patient Registration to support efficient patient access, accurate scheduling and registration, and timely completion of insurance verification and authorization requirements. This position performs assigned duties within one or more of these areas based on departmental needs, staffing availability, workload, and the employees’ training and competency. The position is not expected to perform all departmental functions simultaneously.

ESSENTIAL FUNCTIONS

Central Scheduling

• •Schedule diagnostic imaging, outpatient procedures, and other services as assigned, following established scheduling protocols and provider orders.
• •Contact patients to schedule appointments, confirm appointment details, and provide preparation instructions as appropriate.
• •Verify that orders contain the necessary information to facilitate accurate and timely scheduling.
• •Review scheduling work queues, waitlists, and outstanding appointments as assigned.
• •Communicate with patients, providers, clinical departments, and other internal customers to resolve scheduling questions or issues.
• •Document scheduling activity and maintain accurate appointment information in the applicable systems.
• •Assist with scheduling backlogs, high-volume periods, and staffing coverage needs.

Central Authorizations

• •Verify patient insurance eligibility and benefits for scheduled or ordered services.
• •Review payer requirements to determine whether prior authorization, precertification, or referrals are required.
• •Contact insurance payers and submit required documentation to obtain authorization for services ordered by or performed at Western Missouri Medical Center.
• •Monitor authorization status and follow up on pending, denied, or additional-information requests within established timeframes.
• •Assist with resolving authorization-related denials and communicate outstanding issues to the appropriate staff.
• •Document authorization activity, reference numbers, approval details, and other required information in the designated systems.
• •Communicate authorization requirements, status updates, and potential barriers to scheduling or service completion to the appropriate departments.
• •Prioritize authorization tasks according to service dates, payer requirements, and departmental workflows.

Patient Registration

• •Obtain and verify accurate patient demographic, contact, guarantor, and insurance information.
• •Verify insurance eligibility and benefits and identify applicable copayments, deductibles, and other patient financial responsibilities.
• •Collect, review, and accurately enter Medicare Secondary Payer (MSP) information when applicable.
• •Obtain required registration forms, signatures, consents, and other documentation in accordance with established procedures.
• •Review patient accounts and registration information for completeness and accuracy.
• •Communicate financial responsibility and registration requirements to patients in a professional and courteous manner.
• •Follow established procedures for patient identification, insurance documentation, and registration accuracy.

Requirements

EDUCATION/EXPERIENCE/SKILL REQUIREMENTS

• •High school diploma or equivalent.
• •Typing skills of 45+ WPM
• •Previous clerical experience.
• •Great customer services skills.
• •Previous medical support services experience.
• •Must be self-motivated and have the ability to work within the established policies, procedures and practices prescribed by the hospital/clinic

PHYSICAL/MENTAL REQUIREMENTS

• •Must be able to sit and stand, intermittent 8 to 10 hours a day.
• •Must be able to use standard office equipment, including the telephone and computer keyboard.
• •Continuously works under pressure of near 100% accuracy while meeting inflexible deadlines.
• •Continuously utilizes manual/bi-manual dexterity, near vision, speech, and hearing.
• •Frequently stands, walks, sits and utilizes eye/hand coordination and color definition.
• •Occasionally reaches above shoulder, regularly required to lift and/or carry up to 40 lbs.
• •Occasionally walks on uneven surfaces.