At White Plains Hospital, you have an opportunity to work side-by-side with some of the most talented people in the world.
We have been widely recognized for our exceptional culture, world-class physicians, Magnet-designated nurses and passionate employees who make a real difference in our community. With tremendous growth opportunities, great benefits, and flexible work schedules, it is no wonder why we are consistently recognized as a Great Place to Work.
Position Summary
Responsible for reviewing all inpatient admissions and inpatient and outpatient scheduled procedures coming into the hospital for accurate patient demographic and insurance information for revenue cycle processing. Fulfills the pre-certification requirement as set forth by various insurance companies for inpatient admissions. Verifies and completes pre-registration elements for all inpatient admissions and outpatient procedures by validating policy effective dates, benefit coverage and identifying applicable financial responsibilities. Responsible for completing the pre-admission and pre-registration tasks for patients to be serviced in the surgical areas of the hospital and communicate and escalate insurance needs to refer providers and leadership.
Essential Functions and Responsibilities Includes the Following:
1. Understands and adheres to the WPH Performance Standards, Policies and Behaviors.
2. Documents patient demographic and insurance information prior to commencement of care for scheduled procedures and documents accurately within the registration system.
3. Actively reviews all admissions to the hospital for active insurance coverage.
4. Processes insurance specific requirements for admission to the hospital within 24-48 hours of admission
5. Identifies patients without coverage who are admitted to the hospital and appropriately refers to hospital identified resources for insurance enrollment and assistance.
6. Pre-registers patient procedures using the hospital approved EMR tools with high accuracy and attention to detail
7. Performs insurance benefit verification and prior authorizations validation tasks as needed utilizing the various tools made available by the hospital to complete verification tasks as efficiently as possible for different insurance payers
8. Responsible for POS collection process as required including contacting patients for collection of payments as identified by the insurance payer.
9. Utilizes appropriate steps in the decision-making process to include recognition and priority setting related to patient care and practice-based issues
10.Must be able to communicate with patients over the phone and at times via hospital approved electronic correspondence who have questions about their bills/financial obligations. Must be able to convey and exchange accurate information and process payments as necessary.
11.May prepare and maintain various statistical data.
12.Collaborates and communicates effectively with the referring provider office staff. Serve as a liaison to physician offices and surgical area for all insurance and payment matters.
13.Serves as liaison with patient customer service representative including but not limited to matters related to insurance verification and prior authorizations processes.
14.Demonstrates a cooperative spirit within the team and communicates effectively
15.Responsible for answering incoming telephone calls and responding in an appropriate manner to resolve calls efficiently and effectively. Relays messages as needed.
16.Maintains the physical and electronic fax machines, distributes faxes as necessary
17.Maintains files and assists in establishing office systems.
18.Utilizes cost containment practices.
19.Fulfills organizational responsibilities as assigned including respecting/promoting patient rights; responding appropriately to emergencies; communicates concerns/ problems relating to patients and/or staff with immediate supervisor
20.Completes annual mandatory requirements including Occupational Health Requirements
21.Adheres to all WPH policies and procedures including dress code, behavioral standards/code of conduct, customer service and attendance
22.Performs all other related duties as assigned
Education & Experience Requirements
ï‚· High school diploma or general equivalency diploma (GED required).
ï‚· Experience with electronic scheduling, registration and medical record systems required. Knowledge of Epic or Meditech is a plus.
ï‚· Knowledge and experience with insurance verification and prior authorization processes highly preferred.
ï‚· Knowledge to perform non-complex arithmetic calculations when compiling summaries and other statistics at the level normally acquired through the completion of high school.
ï‚· Previous experience in a clinical setting is highly preferred including general knowledge of medical terminology
Core Competencies
Ability to work independently and collaboratively
ï‚· Ability to multitask
ï‚· Ability to communicate effectively both verbal and written.
ï‚· Must display an empathetic, enthusiastic and positive attitude.
ï‚· Must demonstrate courtesy, cooperation, and professionalism toward patients, co-workers, supervisors, physicians and all hospital staff.
ï‚· Must recognize and respect patient confidentiality.
ï‚· Must have the ability to prioritize multiple responsibilities.
ï‚· Must have the ability to concentrate on fine detail with interruption and attend to multiple tasks.
ï‚· Must have the ability to follow written and/or oral instructions.
ï‚· Must exercise good judgment in accordance with departmental policies and procedures
ï‚· Must have the ability to concentrate on fine detail with interruption and attend to multiple tasks.
ï‚· Must be able to speak clearly, answer the phone in a friendly and professional manner.
ï‚· Must be able to remain flexible in a work environment undergoing significant changes in the next 1–3 years
Physical/Mental Demands/Requirements & Work Environment
May be exposed to chemicals necessary to perform required tasks. Any hazardous chemicals the employee may be exposed to are listed in the hospital’s SDS (Safety Data Sheet) data base and may be accessed through the hospital’s Intranet site (Employee Tools/SDS Access). A copy of the SDS data base can also be found at the hospital switchboard, saved on a disc. Must be able to remain stationary for extended periods of time (3-4 hrs.). Must be capable of hand and eye coordination. Must have the ability to perform repetitive functions. Must be capable of concentrating for extended periods of time. Must have the ability to follow supervisor instructions and/or respond to requests. Must be able to see objects closely and far away and hear normal sounds with some background noises. Must be able to communicate ideas and explanations well through verbal and written methods.
Primary Population Served
Check appropriate box(s) below:
☒Adult (18 – 64 years)
☒Geriatric (> 65 years)
The responsibilities and tasks outlined in this job description are not exhaustive and may change as determined by the needs of White Plains Hospital.
Salary Range: $39,923.72-$59,885.48