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Job Title: Admission Representative

Company: Bon Secours Community Hospital

City/State: Port Jervis, NY

Category: Clerical/Administrative Support

Department: Patient Registration

Position: Full Time

Hours: mon-fri 9a-5p

Shift: Day

Req #: 23447

Job Details:

Job Summary:

The Notice of Admission Representative is responsible for collecting and reviewing demographic and insurance information from inpatient records to verify insurance information and eligibility. This position notifies the patient’s insurance company of admission and ensures that services provided will be authorized, denials and appeals minimized, and payments expedited. In addition, the NOA provides superior customer service and adheres to the productivity, accuracy and performance measures established for the department.

Responsibilities:

Monitors and reviews inpatient records to identify specific insurance coverages requiring notice of patient admission within a specified timeframe. Notifies insurance companies via telephone, on-line electronic transmission, and/or facsimile transmission of inpatient hospital admissions. Performs a review of the patient demographic information, reviews insurance documents and validates insurance eligibility by using the insurance grid, RTE, and multiple patient information systems. Reviews the filing order of insurances to ensure accuracy. Reviews MSPQ filing and corrects, as appropriate, to ensure that accurate payer information is available. Completes and submits, if required, detailed and accurate documentation of inpatient admission for submission. Attains correct benefit information from insurers. Resolves any issues with coverage(s) and escalates complicated issues to manager. Provides clear, concise and accurate documentation of all calls and benefits information into the EMR. Reviews registration data for accuracy and satisfies delinquent data for quality assurance. Adheres to current processes and workflows to avoid denials and loss of payment. Completes all on-line education modules and attends department trainings. Performs other duties as assigned.

Qualifications / Requirements:

Experience:

Minimum of 3-5 years of healthcare experience in a patient admissions/medical billing environment with knowledge of medical insurance plans (Medicare, Medicaid and Commercial) preferred. Must possess a working clinical knowledge of commonly used healthcare concepts, practices and procedures with particular emphasis on inpatient admissions as well as ICD-10 and CPT Codes.

Education:

High School diploma or GED required

Licenses / Certifications:

N/A

Other:

If applicable, the individual performing this job may reasonably anticipate coming into contact with human blood and other potentially infectious materials. Individuals in this position are required to exercise universal precautions, use personal protective equipment and devices, and learn the policies concerning infection control.