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HUMAN RESOURCES JOB DESCRIPTIONS / Admissions

SUBJECT: Patient Representative/Authorization Coordinator HRJD.085

JOB DESCRIPTION

Patient Representative/Authorization Coordinator

Department: / Admissions
Reports to: / Business Office Manager

JOB DUTIES & RESPONSIBILITIES

Job Summary:

Under direct supervision of the Business Office Manager the Patient Representative/Authorization Coordinator meets with patients for same day registration and preregistration for inpatient and outpatient surgeries. Coordinates with physician offices to verify that all necessary insurance authorizations are received for inpatient, outpatient and diagnostic procedures to be performed at Stanislaus Surgical Hospital (SSH). Works with Admissions Supervisor on patient questions and issues.

JOB SPECIFICATIONS

Education:

High School Diploma or equivalent

Experience and Skills:

1.  Minimum of 3 years in admitting for health care organization

2.  Minimum of 2 years insurance verification and authorizations

3.  Familiar with CPT, HCPCS, ICD 9 and DRG codes

4.  Able to read and understand insurance payer contracts

5.  Professional appearance

6.  Use of proper grammar and spelling

7.  Excellent Communication skills

8.  Excellent Customer Service skills

9.  Dependable

10. Excellent Organization skills

Job Duties:

1.  Review all surgeries and procedures for the following day to verify if we have necessary authorizations.

2.  Assist Unit Clerk/Discharge Planner with authorizations for inpatient or observation patients.

3.  Notify upcoming patients of copays/coinsurance amounts owed at time of service

4.  Back up Insurance Verification/Payment Specialist

5.  Meet with surgical patients for same day registration and pre-registration

6.  Review the following with patients:

a.  Verification of demographics

b.  Verification of insurance and benefits

c.  Patient co-insurance amount

d.  Arrival time for surgery

7.  Follow SSH guidelines for making financial arrangements with patients

8.  Review all necessary forms: advance directives, and privacy policy (HIPAA)

9.  Oversee training of new employees

10. Performs other job duties as they are assigned

For the purpose of the American Disability Act (ADA), this position has been assessed to identify essential and marginal functions. Tasks listed below are considered to be essential functions of the job. Reasonable accommodations may be made for individuals with qualifying disabilities in order to perform the essential function of the job.

  1. Work Position
  1. Sitting 90% or more
  2. Standing 5% or more
  3. Walking 5% or more
  1. Body Movements
  1. Lifting/Carrying up to 20lbs Frequency, less than 15%
  2. Bending and stooping Frequency, less than 25%
  3. Hand grip, wrist and digital dexterity Frequency, 60%
  1. Speaking, hearing and visual acuity to receive and interpret instructions
  2. Verbal and written English communication skills
  3. Mathematical and reasoning Skills
  4. Normal vision range. Ability to distinguish letters, numbers and symbols
  5. Requires the use of office equipment, such as computer, telephones, photocopier, and scanner and FAX Machine

Employee Signature / Date

D. Martin

Revised: 3-Jul-15

Approved: 20-Aug-14