Admitting Representative

Job Summary:

Under the direct supervision, performs pre-admits and admits based on doctors orders. Directs visitors and patients to the appropriate area and answers phones. Interviews patient and/or their representative to obtain demographic and financial information. Identify available payer sources and records information required for admission and/or registration. Reviews and assists patients to complete all required documents for completeness and appropriate signatures. Verifies insurance eligibility and benefits. Collects any cost shares due to include but not limited to co-payments, deposits, share of cost (SOC) and deductibles. Initiates and collects financial documents in support of all billing activities. Document KPHC and other systems as appropriate. Assembles accurate and complete records; prepares identification armbands; receive and release patient valuables. Explain hospital rules and regulations. Generates and distributes documents/reports to appropriate departments. Complies with organizational and departmental policies and procedures.

Essential Responsibilities:

• Interviews patient and/or representative, collects/records all required financial demographic information including but not limited to coordination of benefits (COB), third party liability (TPL) and workers compensation (WC).
• Verifies patients identification and insurance eligibility/benefits.
• Notify insurance company of admission status.
• Obtains authorization/pre-certifications and required billing information from all identified payer sources for Medical Office/Hospital Services rendered.
• Coordinate and informs patients of required financial obligations.
• Collect any cost shares due to include but not limited to copayments, deposits, share of cost (SOC) and deductibles.
• Reviews all required documentation with patient, ensuring completion and obtain all necessary signatures.
• Accurately document all requisite information related to the admission and collection processes in KPHC and other systems as appropriate.
• Refers to Financial Counselors for patients having a financial obligation to Kaiser Permanente as necessary.
• Explains admission process, hospital regulations, policies and procedures.
• Contacts physician if additional information is needed.
• Prepares patient armbands.
• Create patient file with all necessary documentation for bill completion.
• Generate and distributes appropriate registration/admission documents.
• Secures and releases patient valuables for patients admitted into the hospital.
• Escorts or arranges escort of patients to assigned room or area.
• Performs pre-admission function including but not limited to surgery and labor & delivery cases; inputs required data for the anticipated admit list, balancing and checking for accuracy and completeness.
• Collaborates with physicians, nursing and other departments to facilitate admission and transfer
• Responsible for proper monetary transactions as it relates to assigned cash drawer.
• Prepares bank deposit slip and contacts security for escort to deliver bag containing shift deposits to the designated safe.
• Responsible for completing cash drawer transmittal forms, keeping designated dollar amount of money in the cash drawer daily and balancing out at the end of the shift.
• Research and reconcile cash drawer issues.
• Distributes related monetary documents as required and maintain/control of petty cash fund.
• Hospital cashiering/cash handling functions to include deposits, exchange and change fund functions, web declarations and other hospital cashiering functions as assigned.
• Manually estimate MOOP along with submitting refund request if necessary, review and maintain hospital exchange fund and petty cash transactions.
• Totals and reconciles, credit charges and payments on account with standard processing forms.
• Mails information as required.
• Provides co-payment history statements
• Review and complete accounts in work queue(s). Notify management of any copay discrepancy.
• Consolidates or corrects duplicate accounts by using appropriate system functions. Enters account notes on patient cases.
• Performs clerical duties as assigned, including but not limited to, filing, faxing, scanning, processing of mail, supplies, printing, answering and redirecting calls as needed for the department.
• Review various reports (census, unbilled, etc.)
• Provide front-end coverage to other functional areas within admitting and provide support to ancillary departments as necessary.
• Provides patient with appropriate documentation and information for Medical Financial Assistance Program (MFAP).
• Assist in Quality Improvement monitoring as necessary.
• Perform reception duties as required including but not limited to answering phones, calling patient family when necessary, greeting members at the Front Desk and relieving other clerks for breaks and lunch as appropriate.
• Work with financial counselor related to patient financial ability.
• Establishes and maintains courteous, cooperative relations when interacting with other personnel, Health Plan members and the public.
• Performs other duties as assigned by management team and/or lead admitting clerk.