General Summary

• Under limited supervision oversee the pre-registration process for all scheduled and unscheduled inpatient admissions, outpatient procedures and ambulatory services by verifying eligibility, benefits, coverage limitations, deductibles and co-payments.
• Responsible for overseeing the Medical Assistance Eligibility, Self Pay receivable, Charity Care process and Financial Clearance for UMMS, Kernan, and Specialty Hospital.
• Serve as resource to resolve issues related to admissions.

Principal Responsibilities and Tasks

The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job duties performed by personnel so classified.

The duties below apply to all areas of responsibility, Pre-Registration, Medical Assistance Eligibility, Self Pay receivable and Charity Care process.

• Assists in the management and direction of the hospitals Pre-Registration department to include assisting with planning, organizational development, staffing, registration, and staffing related activities. Applies Medical System policies and procedures, federal, state and local statutes governing the delivery of health care services.

Ensure the successful management of daily team operations; hold self and others accountable for performance.

a. Provides direct supervision of employees engaged in the department. Delegates authority as appropriate. Maintains employee work schedules ensuring adequate staffing levels to preserve optimal provision of services.

b. Hire, orient, train, conduct performance evaluations, handle disciplinary issues, and provide an open and goal oriented work environment with establish clear and concise work procedures and productivity standards.

c. Establishes and communicates staff performance standards for each individuals job function, monitors productivity and quality indicators to meet departmental standards. Approves merit adjustments, leave time and maintains leave records.

• Spearheads internal projects through scoping, planning, testing, implementing, and monitoring activities assigned by the Senior Manager of Pre-Registration.
• Attends internal meetings and collaborate with other Managers, Department Administrators and outside third parties/vendors as needed. Serve on committees.
• Generates daily reports for admissions, gather and sort documentation for authorization and/or referral information verification by staff. Print, review, and maintain processing of daily reports

(i.e. Midas Newborn and Medicare In-house reports, etc.) requiring additional insurance verification. Audits and monitors inpatient admissions and outpatient registrations daily

a. Assists in developing and monitoring departmental operating and patient-flow tracking and reporting mechanisms and information systems regarding hospital census and bed availability, and Admission, Discharge and Transfer (ADT) information

b. Assists in monitoring the efficiency and effectiveness of registration activities, assuring that information taken from prospective patients is accurate and complete, ultimately contributing to the successful reimbursement to the hospital for patient services

• Assists the Sr. Manager, Pre-Registration in the development, implementation, review and update of department administrative policies and procedures by applying relevant legal, ethical, The Joint Commission and Medical System guidelines to assure consistent and efficient departmental operations. Communicates, interprets and assists in ensuring compliance with it to staff.
• Keeps abreast of current regulatory (federal, state and the joint commission) information / guidelines and new, related hospital policies; communicates relevant changes and/or protocol and procedural revisions to staff. Implements appropriate department operational changes to ensure compliance. Attends and participates in various training and educational programs to remain up-to-date on admitting, quality assurance and various relevant health care issues and for professional growth and development.
• Conduct regular team and departmental (in conjunction with the Senior Manager, Pre-Registration) meetings for purposes of education, goal monitoring, and feedback inquiries. Submits timely minutes of meeting to the Senior Manager; attend regular meetings with the Senior Director of Patient Financial Services and other Managers. Perform the functions of subordinate staff as needed due to staff absenteeism or other performance related issue to remain current.
• Maintain a thorough working knowledge of payer source information requirements as defined or reported by the Senior Director of Patient Financial Services. Review difficult or unusual cases to ensure accurate assessment of financial circumstances and eligibility determinations.
• Utilizes patient access intelligence to evaluate a self pay patient's ability for payment. The evaluation will consist of patient payment estimation, charity care screening, Medicaid Eligibility review, address validation and risk assessment. Collects co-payments and deductibles during the pre-registration process.