Registration/Scheduling Representative I - TVC 1st Care Clinic

Responsibilities include pre-registration, receiving physician orders, insurance verification, gathering pre-authorizations, scheduling, and pre-certifications for assigned area. Maintains records and produces statistical reports as required. May distribute educational materials to patients and families if needed in assigned department. Performs financial counseling when appropriate. Explains and obtains signatures on hospital legal forms i.e. Conditions of Admission, Financial Agreement, Advance Directive, Hospital Grievance policy.

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  Receives physician orders and seeks clarification, if necessary. Performs pre-registration/registration processes, verifies insurance coverage and obtains pre-authorizations and pre-certifications and notifications. Accurately and completely documents all information into the patient records system to ensure maximum reimbursement. May obtain all necessary signatures and documentation, as appropriate.

• Coordinates prior authorizations for patient treatments or diagnostic procedures. Resolves scheduling conflicts, as needed. Documents all information regarding patient re-schedules. Utilizes computerized scheduling systems.

• Enters patient information in computerized scheduling system and gathers information and modifies records, as needed to maintain current database. Prepares charts and manages files within regulatory requirements. Compiles and reports statistical data, if needed by the assigned department.

• May calculate patient liability according to verification of insurance benefits, collect deposits and copayments. Distributes educational materials to patients and families, when necessary. Responds to diverse questions or refers to appropriate clinical staff.

• May provide financial counseling to patients and their families. Explains FHP financial policies and provides information as to available resources and avenues for alternative payment arrangements. Assists patient and their families in completing financial assistance paperwork when appropriate.

• Provides administrative support to the assigned unit when required.

• Meets or exceeds productivity standards. Completes daily assignments and maintains accurate production logs and records. Identifies opportunities to improve work processes and practices good work group dynamics.

Performs all functions according to established policies, procedures, regulatory and accreditation requirements, as well as applicable professional standards. Provides all customers of Foundation Health with an excellent service experience by consistently demonstrating our core and leader behaviors each and every day.

High school diploma/GED or equivalent working knowledge.

Requires skills and abilities typically attained with one (1) or more years of medical clerical experience. Medical terminology knowledge is required. Must possess excellent organizational skills, as well as effective human relations and communication skills.

Must be proficient with commonly used office software and computers and possess the ability to use computerized scheduling systems. Must be able to maintain accurate statistical records, gather data, and produce reports.

PREFERRED QUALIFICATIONS

Prior experience in a hospital central scheduling or physician office scheduling setting preferred.

Additional related education and/or experience preferred.