JOB SUMMARY

Duties include prior authorization inquiry for all hospital services. Review insurance contract management program in Rycan and distribute to appropriate biller for review. Review and process various reports. Resolves problems presented by patients. This is an in-person position and regular, on-site attendance is required. 

ESSENTIAL FUNCTIONS

1. Collects and disseminates accurate patient demographic/financial information to internal/external customers and appropriately and timely documenting into computer system all transactions. Back-up registration clerk on the day set by interoffice schedule or as needed.

1.  Answers the multi-line phone systems and directs calls to appropriate extensions.

1. Professional and polite interactions with coworkers and patients.

1. Routine and consistent attendance required. Time off, either requested or not, will follow St. Luke Hospital policies.

1.  Reviews overpayments/underpayments in the Rycan software and distributes to the appropriate biller for action.

1.  Process Small Balance Report.

1.  Review various reports assigned by supervisor as needed.

1.  Performs various and sundry duties as requested by the Business Office Manager or the Financial Director. The incumbent will also assist the CEO as needed.

1. Submit prior authorization requests for the following services

1. Outpatient IV Infusions
2. Outpatient radiology/lab services
3. Inpatient stays
4. Swing Bed (Skilled Nursing) services
5. Therapy Services

10. Daily tasks include: 

            a. Check Census report – Who is admitted.

            b. Prior authorizations as they are presented/requested

            c. Days Not Final Billed (DNFB) Report (weekly – Fridays)

            d. Registration Edits (Daily)

            e. Daily Receipts Report (Match with SPD Sheet ) Slicky to Accounts Receivable Clerk

SCOPE AND COMPLEXITY

Accountabilities for this position: 95% registration accuracy; time and attendance accountability; strive for reduced overtime and reduction in supply waste. Meet expected monthly collection goals. Internal and external customers include department personnel, vendors, insurance agencies/personnel, physicians/staff, patients and their families.

MINIMUM QUALIFICATIONS

• Education/Experience: 

High school education or GED preferred. Prefer two years applicable healthcare experience.

• Technical Competencies:

Must be extremely proficient in computer applications.

Medical terminology proficiency, preferred

General office equipment: fax machine, copier, multiline phone system

Effective organization and interpersonal skills

Ability to cope with multiple tasks and demands

Deal with and articulate sensitive information to patients, families and employees. 

Monday - Friday
40 hours per week