Patient Access Rep; BGH

Reports to the Registration Manager or the Registration Supervisor. Follows established Memorial Hospital of South Bend (MHSB)/Beacon Granger Hospital (BGH) policies and procedures to admit and register patients for services in a professional and courteous manner. Is responsible for accurate and complete registration of all MHSB/BGH patients. Must maintain regulatory and functional knowledge of all information required which ensures timely and accurate reporting/billing.

Collects applicable co-payments and deductibles and completes insurance verification and must be able to accurately decipher eligibility responses and relay that information back to the patient. Performs daily cash balancing procedures. Obtains all required signatures on paperwork and performs clerical duties as necessary.

• MISSION:
  We deliver outstanding care, inspire health, and connect with heart.
• VALUES:
  Trust. Respect. Integrity. Compassion.
• SERVICE GOALS:
  Personally connect. Keep everyone informed. Be on their team.

Registers Patients (in Order To Obtain Demographic, Physician And Insurance Information In Accordance With Established Departmental Policies And Procedures) And Collects Applicable Co-payments And Deductibles By

• Verifying insurance coverage and network status by using online eligibility systems and websites to determine the patient's benefits under the insurance plan.
• Audit insurance eligibility by using the Relay Connect dashboard to verify insurance is eligible and correct.
• Verify network eligibility for potential transfers for Transfer Direct.
• Obtaining VOB information from the insurance company, such as: co-payment, co-insurance, deductible, the amount of the deductible that has been met year-to-date, family deductible, maximum out-of-pocket limit and rehabilitation benefits.
• Obtaining pre-certification information from the insurance company's pre-certification unit (i.e., whether pre-certification is required, if the ordering physician has completed it, etc.).
• When the ordering physician has not completed the pre-certification, calling the physician's office to initiate the pre-certification process and following up until it has been completed.
• When the ordering physician has completed the pre-certification, documenting the authorization and releasing the account.

• Preparing patient statistics (i.e., percentages) regarding completed demographic information as requested by the Director and/or Manager.
• Processes utilization review emails and physician orders to complete change patient types in Star.
• Works mismatch report to ensure that all patient types match the level of care order.
• Printing itemized bills for the patient upon receipt of co-payments or coinsurance (if requested).
• Entering authorization number in the appropriate field for proper and timely claims filing.
• Calculating co-payments and coinsurance for services rendered per the insurance companies' request.
• Processing and filing reservations, pre-testing forms and testing results in an efficient manner.
• Process faxes from nursing units, diagnostic departments, Claim Aid, and social services to update patient information, add insurance, and register add on patients.
• Answering the telephone and communicating information in an appropriate manner according to approved MHSB standards and departmental policies and procedures.

• Notifying the assigned Unit of the patient's arrival.
• Preparing the patient's chart,  and labels for the medical…