Registration Representative - Physician Enterprise

Job Summary

The Outpatient Registration Representative is a vital member of the Physcian Enterprise ensuring a smooth and positive experience for all patients from their initial contact to their departure. This role is responsible for a comprehensive range of administrative duties, prioritizing patient satisfaction, accurate information management, and efficient office operations. Primary duties include:

• Appropriate patient identification
• Collecting accurate and thorough patient demographic data
• Obtaining insurance information and verifying eligibility and benefits
• Determining and collecting patient financial liability
• Scheduling & managing appointments
• Greeting & directing patients
• Managing incoming communications

Essential Key Job Responsibilities

1. Patient Registration

• Maintains up-to-date knowledge of specific registration and scheduling requirements for various appointments and services offered by the practice.
• Ensures complete, accurate, and timely entry of demographic, insurance, and scheduling information into the Electronic Health Record (EHR) system at the time of registration and appointment scheduling.
• Properly identifies the patient to ensure medical record numbers are not duplicated and maintains data integrity within the EHR.
• Responsible for reviewing assigned patient accounts to ensure accuracy and all required documentation (e.g., patient forms, intake questionnaires) is obtained and complete.
• Collects and enters required data into the EHR system with emphasis on accuracy of demographic and financial information to ensure appropriate billing and reimbursement.
• Carefully reviews all information entered in the EHR for scheduled appointments. Verifies all information with the patient at the time of check-in and corrects any errors identified.
• Identifies all forms requiring patient/guarantor signature (e.g., consent for treatment, privacy practices, financial agreement) and obtains signatures.
• Identifies all appropriate printed patient education material and hand-outs for the patient and provides them to the patient/guarantor (e.g., practice brochures, new patient packets, HIPAA Privacy Act notification, appointment reminders).
• Follows downtime procedures by manually entering patient information; identifying patient's MRN in the MPI database, assigning a financial number; and, accurately entering all information when the EHR system is live.

2. Verification, Authorization, & Compliance

• Follows approved scripting, verifies insurance benefits on all patients via electronic verification systems or by contacting payers directly to determine the level of insurance coverage for upcoming appointments.
• Thoroughly and accurately documents insurance verification information in the EHR system, identifying deductibles, copayments, coinsurance, and any potential policy limitations specific to outpatient services.
• Verifies any pre-authorization or referral requirements for services to be rendered. If not obtained, initiates the process or notifies the patient and provider accordingly.
• Verifies patient liabilities with payers, calculates the patient's estimated payment for services, and requests payment at the time of service (check-in or check-out).
• Thoroughly and accurately documents conversations with the patient regarding financial liabilities and agreements to pay.
• When collecting patient payments, follows department policy and procedure regarding applying payment to the patient's account and providing a receipt for payment.
• Clarifies division of financial responsibility if payment for services is split between a medical group and an insurance company. Ensures this information is clearly documented in the EHR system.
• Complies with HIPAA, PHI and its implications, ABN (Advanced Beneficiary Notice), and other regulations which affect the registration and billing process in an outpatient setting.

3. Front Office Support & Patient Experience

• Patient Check-in/Check-out: Greets patients warmly upon arrival, assists with completion of necessary forms, and ensures all demographic and insurance information is updated. Facilitates a smooth check-out process, including scheduling follow-up appointments and collecting balances.
• Appointment Scheduling: Schedules new and follow-up appointments efficiently, managing provider calendars, and optimizing patient flow. Assists with rescheduling and confirming appointments.
• Phone Management: Answers incoming calls promptly and professionally, directing calls to the appropriate personnel, taking accurate messages, and addressing patient inquiries regarding appointments, billing, or general practice information.
• Office Communication & Mail: Manages incoming and outgoing faxes, mail, and other correspondence. Distributes information to appropriate staff members.
• Waiting Room Management: Ensures the waiting area is clean, organized, and comfortable for patients. Monitors patient wait times and proactively communicates any delays.
• Referral Management: Processes incoming and outgoing patient referrals, obtaining necessary documentation and communicating with other practices as needed.
• Supply Management: Assists with monitoring and ordering office supplies to ensure smooth operations.
• General Office Support: Provides general administrative support to the office staff and providers as needed, including scanning, filing, and data entry.

4. Financial Processing & Assistance

• Explains the practice's payment and billing assistance programs to patients and refers them to designated billing staff or resources as appropriate for complex financial inquiries.
• Acts as a resource to patients and clinical staff regarding insurance benefits and requirements for outpatient services.
• Documents any financial discussions and referrals in the EHR system.
• Understands and follows the Cashier policy and procedures for payment collection.
• Properly handles credit card transactions in accordance with PCI-DSS standards and guidelines.

Education Requirements

• High School diploma required
• An associate degree in business, healthcare administration, or a related field is preferred.