Registration Specialist (69774)

Character First qualities:

• Decisiveness- The ability to recognize key factors and finalize difficult decisions.
• Dependability- Fulfilling what I consented to do, even if it means unexpected sacrifice
• Initiative - Recognizing and doing what needs to be done before I am asked to do it.
• Thoroughness - Knowing what factors will diminish the effectiveness of my work or words, if neglected.
• Flexibility - Willingness to change plans or ideas without getting upset.

Summary of Duties and Responsibilities:

The Registration Specialist is responsible for ensuring efficient and accurate loading of patient registration information into the OCHIN Epic system prior to the patient's scheduled appointment. This role requires meticulous attention to detail and strong organizational skills. It is preferred that the candidate maintains a strong understanding of Oklahoma FQHC billing requirements. The specialist will work closely with operations, billing, EHR Support Analysts, and other administrative professionals to streamline workflow and enhance patient care delivery.

Primary Duties and Responsibilities:

• Proficient understanding of insurance Medicare, Medicaid, and Commercial requirements.
• Completes chart audits of the insurance and revenue cycle requirements including EPIC data entry and required FQHC documents prior to patient appointments and communicates to leadership as needed.
• Proficient in understanding Revenue Cycle Management, impact of insurance benefits related to patient care, and patient balances.
• Experts in telephonic registration and accuracy of data entry and verification of benefits. This role impacts the ability to ensure clean claims and accurate billing, reducing denials and errors.
• Supports the compliance requirements as an FQHC, including but not limited to: SFS, Proof of Income and other key financial documents.
• Complete insurance verification 3-5 days prior and place electronic verification notes in Epic accurately and timely. Clearly communicates the required documents needed to be obtained at time of check-in at the clinic.
• Performs batch and individual eligibility verification utilizing the Insurance Eligibility (IE) function in Epic or other Insurance portal as needed.
• Submit electronic insurance verification through Epic, insurance website portals or call insurance companies to inquire about eligibility, benefits information, and payment for services.
• Maintain knowledge of all contracted insurances and programs accepted at Variety Care
• Provide direct support to clinics regarding eligibility inquiries.
• Ensure accurate insurance eligibility, benefits and financial information needed for billing and collection processes.
• Ability to complete a high volume of benefit verification requests.
• Refer PCP changes to our Clinic Administrator, provider and operations director. when needed.
• Inform patients, if needed, of their PCP, benefits and financial responsibility.
• Work closely with sites, insurance carrier and patients.
• Apply Sliding Fee Discount Program (SFDP) discounts as necessary. Ensure Declaration of income documentation has been captured.
• Provide customer service internally and externally with professionalism, courtesy, knowledge, and follow through.
• Function at highest level according to eligibility competency.
• Upholds Medicare, Medicaid, and HIPAA compliance guidelines in relation to billing, collections, and PHI information.
• Follow written and verbal instructions from the Manager of Revenue Cycle Management.
• Participates in special projects.
• Supports Variety Care's accreditation as a Patient-Centered Medical Home and our commitment to provide care to all Variety patients that is Safe, Effective, Patient-Centered, Timely, Efficient, and Equitable. Provide leadership and work with all staff to achieve the goals of the "Triple Aim" of healthcare reform-to improve the experience of care, improve health outcomes, and decrease healthcare costs.
• Embodies the strength of personal character. Places value on being an open and honest communicator who displays high moral and ethical conduct, integrity, adaptability, and sound judgment. Must be a leader in the department and community. Result-oriented problem solver who is responsible and accountable.
• Maintains up-to-date knowledge of the health care industry through participation in local and national associations, review of publications, development of personal contacts, and in continuing education seminars.
• Fosters an atmosphere that promotes quality service to Variety Care patients and internal customers through active involvement, attention to detail, and personal responsibility for patient care and business outcomes.
• As an effective, professional team leader/member confers, communicates, and interacts with all levels of management and staff effectively to coordinate special projects and foster good working relationships that will further the goals and objectives of Variety Care.
• Performs other duties as assigned.

Requirements, Special Skills or Knowledge:

• Proficient understanding of Medicare, Medicaid and commercials requirements
• Must have a minimum of 2 years of work experience in a similar or related position, registration and/or medical billing.
• Proficient understanding of Revenue Cycle Management and how it relates to patient care and patient balances.
• Proficient understanding of insurance eligibility, plans and benefits
• Candidates must have excellent communication and organizational skills
• Computer experience, competency - data entry business application
• Direct experience working with the public in customer service role, in retail or phone.
• Attention to detail and accuracy; motivated self-starter.
• Excellent customer service skills required and ability to handle difficult situations.
• Critical thinking skills to assess and resolve complex patient accounts.
• Possess a strong work ethic and commitment to improving patients' lives.
• Be flexible and adaptable with a drive to go above and beyond.
• High school diploma or equivalent.
• Expert in telephonic patient service and registration.

Preferred Requirements, Special Skills or Knowledge:

• Able to demonstrate excellent knowledge of use of Epic.
• Familiarity with insurance payers and funding sources to include manage care plans.
• Should be proficient with MS Office (Word, Excel, and Outlook).
• Demonstrate an understanding of medical billing terminology, processing of claim and different insurance health plans.
• Enthusiastic, Ability to work efficiently in a fast-paced environment and follow through on processes.