Patient Registration Coordinator

Job Summary

The Patient Registration Coordinator is responsible for the data entry and verification of patient prescription coverage for pharmacy services provided to residents within a senior living facility.  Position is full-time, Monday-Friday, 9:00AM-6:00PM.  Position is also part of a Saturday rotation every 4-5 weeks.  Position is a desk role and works closely with senior living facilities over the phone and via email correspondence. Position is part of the Pharmacy Billing department. 

Pharmacy Billing Department Key Responsibilities

1. Billing and Claim Submission:
   • Coordinate the billing process for pharmacy services rendered to residents, ensuring accurate coding, claim generation, and submission to third-party payers.
   • Verify insurance coverage, eligibility, and authorization requirements for pharmacy claims.
2. Accounts Receivable Management:
   • Monitor accounts receivable (AR) aging reports and follow up on outstanding claims and unpaid invoices.
   • Identify and resolve billing errors, claim denials, and payment discrepancies promptly.
3. Claims Reconciliation and Resolution:
   • Reconcile pharmacy claims with remittance advice statements and payment records to ensure accurate reimbursement.
   • Investigate and resolve claim denials, rejections, and underpayments through appeals and communication with payers.
4. Cash Posting and Reconciliation:
   • Post payments, adjustments, and credits to the appropriate accounts in the pharmacy billing system.
   • Reconcile cash receipts with billing records and bank deposits to ensure accuracy and completeness.
5. Revenue Cycle Analysis:
   • Analyze accounts receivable data, billing trends, and payer reimbursement rates to identify opportunities for process improvement and revenue optimization.
   • Generate reports and metrics to track key performance indicators (KPIs) related to accounts receivable performance.
6. Customer Service and Communication:
   • Serve as a primary point of contact for billing inquiries, disputes, and resolution for pharmacy-related accounts receivable.
   • Communicate with internal and external stakeholders, including payers, residents, families, and pharmacy staff, to address billing issues and concerns.
7. Documentation and Compliance:
   • Maintain accurate and up-to-date documentation of accounts receivable activities, including payment records, collections efforts, and communication with payers.
   • Ensure compliance with federal, state, and payer-specific billing regulations and guidelines.

Preferred Qualifications

• Previous experience as a Pharmacy Technician.
• Previous experience with patient registration or enrollment.
• Experience in accounts receivable management, preferably in a healthcare or pharmacy setting.
• Strong knowledge of medical billing and reimbursement processes, including familiarity with CPT, HCPCS, and ICD-10 coding.
• Experience with pharmacy billing software systems.
• Certification in Healthcare Billing and Coding or Accounts Receivable Management.

Working Conditions

• Works in office area(s).
• Primarily sits at cubicle desk with phone and email correspondence. 
• Is subject to frequent interruptions.
• Communicates with the designated facility staff, nursing personnel, residents, or family members.
• Attends and participates in continuing educational programs.

Education

Must possess and maintain any and all necessary active and unencumbered certifications, degrees, or licenses in the necessary state, to the extent the position requires such certifications, degrees, or licenses.

Specific Requirements

• Must be a supportive team member, contribute to and be an example of teamwork and team concept.
• Must possess the ability to make independent decisions when circumstances warrant such action.
• Must possess the ability to deal tactfully with customers, personnel, residents, family members, visitors, government agencies/personnel, and the general public.
• Must not pose a direct threat to the health or safety of other individuals in the workplace.

Physical and Sensory Requirements (with or without reasonable accommodation) (With or Without the Aid of Mechanical Devices)

• Must be able to move intermittently throughout the workday.
• Must be able to read, speak, and understandably write the English language.
• Must be able to cope with the mental and emotional stress of the position.
• Must function independently, and have flexibility, personal integrity, and the ability to work effectively with customers, residents, personnel, and support agencies.
• Must meet the general health requirements set forth by the policies of this company, which include a medical and physical examination if the position requires.
• Must be able to push, pull, move, and/or lift a minimum of 50 pounds to a minimum height of 5 feet and be able to push, pull, move, and/or carry such weight a minimum distance of 50 feet.

All Other Duties as Assigned.

I understand this job description and its requirements; I understand that this is not an exclusive list of the job functions and that I am expected to complete all duties as assigned; I understand the job functions may be altered by management without notice and that I am an at-will employee.

Accommodations

The company is an equal opportunity employer and recognizes that an individual with a disability may require accommodation to enable the individual to successfully perform a job function. I understand that I should discuss with my supervisor any needed accommodation. I agree to cooperate with the company in identifying and discussing any available reasonable accommodation that may enable me to perform the essential function(s) of my position.