Greets, provides information, and responds to the needs of patients, families, staff, and other visitors at the check-in/out desk including appointment check-in and out, registration, authorization/verification of insurance(s), explanation  of benefits; collection of co-pays, assistance with way finding, or other services or resources for a program specific multi-discipline department.  Interacts in a customer focused manner during referral processing.  Provides office support for all Scheduling and Patient Financial Services staff.  Works cooperatively with other departments and outpatient staff/leadership to assure financial reimbursement for outpatient services.

Essential Job Responsibilities:

Greet, provide information, and respond to the needs of patients, families, staff, and other visitors at the check-in/out desk. Triage inquiries that arise during or after each patient/visitor/staff encounter.  Escort and/or direct patients and other parties to other service areas or locations.

Review referrals and other documentation according to internal policy and regulation as applicable in order to assure that the service being provided has been appropriately documented and meets all known payer medical necessity and other criteria.

Review appropriateness of ICD10 and CPT codes to determine if care provided corresponds to reason for referral/authorization to ensure that patient's insurance covers the evaluation/treatments.

Accurately collect and analyze all required demographic, insurance/financial, and clinical data elements necessary to pre-register and register all types of patients.  Accurately record and electronically enter the information on a timely basis into EMR to include assigning a medical record number to new patients.  Accurately prepare and distribute all required registration forms to other internal parties as appropriate and on a timely basis. 

Secure and witness all required signatures according to internal policy and regulation, as applicable with explanation of documents per department standards, including consent to treat, assignment of insurance benefits, Release of Information, Advance Beneficiary Notification, and financial responsibility.  Forward appropriate documents/information to the Patient Financial Services Department to support billing and collections and other departments as needed.

Accurately generate patient specific Explanation of Benefit Forms/Patient Benefit Summary for the multi-disciplinary cost (multiple copays per day and total coinsurance for multiple disciplines if applicable) and distribute to patients/representatives and appropriate internal parties on a timely basis.  Upload the information to the EMR and accurately update information on MFB TeamSite.

Coordinate/schedule initial evaluation and subsequent patient appointments for multi-disciplines based on patient needs (finding appointments for PT/OT/SP on the same day or times that run concurrently) following scheduling protocols and using MFB TeamSite for all patient referrals, follow-ups and authorization tracking.  Inform UR if multiple services will be using the same authorization for visits used.

Obtain, monitor and update insurance authorizations for multi-disciplinary patients (cross-monitor authorizations when PT/OT/SP are all combined and count towards the number of approved visits, monitor/coordinate authorization usage with other departments i.e. patient is being seen for same services in two different service programs).

Coordinate and follow-up on multi-disciplinary patients with designated diagnosis, i.e. post-concussion, to ensure they receive all necessary program-specific care (clinic visit, psychology, nutrition, rec therapy) in addition to the necessary therapies.  Obtain specialty program authorization as needed (i.e. cognitive speech therapy).

Manage calls from insurance/car