Under the direct supervision of the Admitting Manager/Supervisor/Designee, the Admitting Representative is a patient service professional responsible for coordinating & completing every phase of the admission function including admissions, preadmissions, interviews for financial & demographic information, obtains & processes advance directives, obtains patient/agent signatures, may initiate valuables collection & distribution, document preparation for all elective, direct &/or emergency admissions, revenue collection in all settings, & data retrieval. Assures confidential treatment of all communications written & verbal. Will initiate & maintain patient room assignments & status until discharge. Acts as a primary informational resource & provides assistance to both internal & external customers. The Admitting Representative must be capable of making decisions & working independently to achieve all departmental functions, as well as maintain an in-depth underst&ing of job duties & changes as admitting decisions have significant financial & medical implications.
Essential Functions:• Instruct & review with patient, information concerning hospitalization
• Ascertain health plan status, research eligibility & collect & copy non-KP insurance information
• Identifies all uninsured or under-insured patients admitted to facility; refer to Financial Counselors for further action
• Obtains verification & necessary pending authorizations from non-KP insurers (including Medicare, Medi-Cal & COB) on members & non-members when Financial Counselor is not available
• All documentation is completed in the Member Integrated Tracking System (MITS) or the appropriate KP tracking system
• When Financial Counselor is available, discusses the need to obtain authorizations from non-KP insurers
• Promote patient satisfaction & retention through the successful facilitation of the revenue collection process
• Calculate member liability based on benefit plan
• Inform patient/agent & collect appropriate cost share payments for services rendered in all settings (e.g. bedside, follow up phone calls to patient's home, etc.)
• Notify patient & when possible collect financial liability for elective procedures & document all interactions
• Contact all discharged patients to attempt collection of financial liability & document all interactions
• Research payment records of all non-paying patients with liabilities, utilizing system records
• Reports findings to Manager/Supervisor/Designee
• Analyze revenue data to determine obstacles in cost share collections
• Report daily/weekly to Manager/Supervisor/Designee.
• Collects all information necessary to bill second-party payers
• Interview patients for pre-admission or admission to the hospital, collecting personal, demographic, financial, & medical information in person or by phone per KP policies
• Enter complete data into the KP information systems & review for accuracy per department, local, regional, & regulatory compliance
• Affix identification bracelet to the patient's wrist on the side of the body opposite the intended procedure or injury per local policy
• Underst& & abide by the HIPAA regulations & KP Corporate Compliance
• Provide up-to-date information concerning admission & hospital practices & administrative procedures per HIPAA guidelines
• Evaluate & attempt to resolve/refer public & patient concerns as they arise
• Facilitate the timely admission of patients throughout the hospital by coordinating patient information w/the physicians, Emergency Room, Clinic Departments, House Nursing Supervisor, Patient Care Unit Staff, & outside Care Coordinators per local policy
• Receive admission requests
• Facilitate appropriate bed assignments & communicates information to staff
• Maintain accurate record of cost share status of all patients with liabilities, utilizing revenue tracking system as determined by management
• Obtain appropriate signatures on permits & consents per California Hospital Association (CHA) consent guidelines
• Prepare related admission paperwork in advance to facilitate a timely admission process
• Assemble & coordinate admission materials to create a comprehensive admission package
• Distribute relevant brochures/letters to patient/agent (e.g. Medicare letter, Coordination of Benefits (COB) Brochure, advance directive brochure, cost share letter, etc.)
• Receive, document, secure & release patient valuables according to St&ard Procedure 18A as appropriate
• Initiate membership records on all newborns per local policy
• Distribute admission materials to proper locations
• Participate in problem-solving as needed to assure organizational revenue targets & customer satisfaction
• Escort or arrange for patient escort to assigned room or area per local policy
• Answer phones in a professional, courteous & positive manner promoting excellent customer relations when providing information/directions to physicians, staff & public
• Maintain high st&ards of excellence & assist Kaiser Permanente fulfill its mission by providing high-quality health care services
• Work in a team environment continually enhancing required skills through scheduled training sessions or individually
• Attend required meetings, workshops & in-services
• Provide support in conducting audits depending upon supervisory need
• Perform other related duties as required
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