UNM Sandoval Regional Medical Center ยท 1 day ago
REGISTRATION & ELIGIBILITY SPECIALIST - CWA
Rio Rancho, NM
Full-time
Onsite
Entry Level
$16.59/hr - $22.95/hr
2+ years expUNM Sandoval Regional Medical Center is seeking a Registration & Eligibility Specialist to perform pre-registration and registration functions for Ambulatory/Outpatient Operations. The role involves verifying insurance coverage, assisting patients with financial options, and ensuring adherence to hospital policies.
Hospital & Health Care
Responsibilities
Assist patients in locating departments; schedule and coordinate patient appointments; refer patients and families to appropriate services and resources
Provide information and assistance to internal and external customers; provide and ensure quality service and customer satisfaction
Perform data entry and research using various hospital system programs
Enter various data into computer; verify data, make corrections and ensure accuracy
Interview patients and/or families to obtain demographic, financial information and signatures as required; schedule new and follow-up appointments
Verify insurance coverage and benefits on patients needing an Auth; provide notification of admission and obtain auth for emergency admits; obtain authorizations for same day surgery, inpatient surgery, direct admits and any other pre scheduled stays or procedures. Provide all pertinent medical history/documentation for insurance companies and other payors in order to obtian an auth; document Cerner with correct information; Scan all documents concerning authorization and reimbursement into Siemens document imaging; may collect down payments for and copays for procedures. Create Pre Admits in Cerner as appropriate
Complete pre-screening process for specialty clinic appointments for referral and/or prior auth
Interview patients and complete the application process for State/Government programs; maintain MOSAA certification with the State; interview and approve patients for UNM Hospital charity and discount programs
Refer self-pay patients for financial assistance; make financial assistance appointments
Determine and process eligibility for financial assistance (Including Medicaid, SCI, UNM Care, Commercial, Medicare, PHS/Indian Health Service, Salud, Self Pay)
Maintain a knowledge of community financial resources and refer patients appropriately (EMSA)
Perform training with registration and admitting personnel to assure proper registration and knowledge of business practices to include financial assistance programs
Perform outreach/training with clinical areas to ensure process flow remains tight and to maintain open communication
Establish and maintain good rapport and effective working relationships with patients, visitors, physicians and Hospitals employees
Enhance professional growth and development through participation in educational programs, reading current literature, attending in-services, meetings and workshops
Perform as liaison between clinic staff, providers, and the insurance company or other payors to coordinate financial benefits/ coverage and prior authorizations
Assign ICD9 or ICD10, CPT codes as required by insurance companies in order to obtain authorization for services
Send all pertinent medical documentation to insurance companies and other payors for approval. Document final authorization in Cerner and scan all paperwork into Siemens scanning
Answer phones at front desk and assist walk-in patients as needed. Provide after hours/weekend information desk coverage for the hospital. Re-identify patients for Blood Bank and Health Information Management Department. Organize folders for floor visits to patients. Admit surgical patients and direct admits that present to the Admitting office. Input all pre-admits for PALS and direct admissions as appropriate. Log all admissions in the Admitting logs
Accept and issue patient's valuables from patients and the Emergency Department Staff. Perform floor visits to interview patients after a direct admit from the Emergency Department or the clinics
Reconcile and complete cash reconciliation reports; balance and post payments, contractual allowances, and denials
Obtain police reports when appropriate for billing information for Patient Financial Services. Do the Census reports for PBX. Work Medicare secondary payor report as assigned
Perform related duties and responsibilities as required
Obtain proper signatures for Medicare Rights Consent for Treatment, financial forms for applying for assistance, and other forms as appropriate; assure that patient rights are distributed
Interview patients and/or family at time of admission, pre-admission or discharge to obtain accurate demographic, and financial information; update information on Hospitals computer system to ensure correct billing; register patients for the Laboratory and clinics after hours; provide billing information to Ambulance Services
Qualification
Required
High School or GED Equivalent
2 years directly related experience
Preferred
Bilingual English/Keres, Tewa, Tiwa, Towa, Zuni, or Navajo
Company
UNM Sandoval Regional Medical Center
At UNM Sandoval Regional Medical Center (SRMC), you benefit from the personal attention of a community hospital and the expertise and resources of an academic health care facility.
201-500 employees
Funding
Current Stage
Growth StageLeadership Team
Jamie Silva-Steele RN, BSN, MBA, FACHE
President and CEO
Adrian Larson, FACHE
Chief Operating Officer
Company data provided by crunchbase