The Registration Services Representative (RSR) is responsible for complete registration & eligibility on non-central scheduled patients, scheduled inpatients and research patients. This includes answering incoming calls for registration and using work lists to ensure all registrations are complete before the patient arrives in the clinic. The RSR enters insurance information obtained from the clinic check-in process, and corrects registrations forwarded via work queues from billing system edits. The RSR is responsible for running electronic eligibility checks, and completing MSP questionnaires for Medicare patients. Information is documented in the Epic system with extreme accuracy to ensure proper billing and collections and customer service.
Primary FunctionsRegisters patients via phone and work lists/reports to ensure complete and accurate registration data is in the Epic system before the patient’s clinic visit.Enter of all patient demographics and insurance and coverage information in software or databases.Ensures compliance policies are followed in order to avoid fraudulent billing, consent forms, and Medicare questionnaires.Verifies Medicare and Medicaid eligibility. Requires full knowledge of on-line eligibility systems.Apply extensive knowledge of miscellaneous and managed care insurance contracts.PSRR may need to call the patient and/or insurance carrier to verify coverage and eligibility as needed.Enters insurance information obtained from the clinic check-in process. This will come via work queues containing insurance card copies, which are scanned or faxed by the clinic. Registration updates will also be made from billing edits, which will also come via work queues.Checks e-mails, Epic work lists and Epic Inbasket regularly throughout the day to keep up-to-date with any changes and receive information on patients who need registration services.Assists with quality control measures and special projects as situations demand.Reviews own work and works reports to verify accurate information and corrects any registration issues.
Knowledge – Skills – Abilities
Knowledge of quality control, customer service standards, information management, procedural process, and recordkeeping.
Computer, technical, interpersonal, oral communication, listening, and patience skills.
Building: Research Park Center
Department: Clinical Practice Services
Reports to (Title): Practice Services Supervisor-Pre-Arrival
Direct Reports (Titles): None
Appropriate education and/or experience may be substituted on equivalent basis
Minimum Required Education: High school diploma
Minimum Required Experience: 2 years of related experience. Typing skills of 30 WPM and
accurate data entry skills.
Grade Name 6
Full-Time Equivalent 1.0
FLSA Status Non-Exempt
FLSA Test Administrative
Workweek Full-time role with expectations for coverage during core business hours and flexibility required as necessary to accommodate business needs.
Job ID 331
Job Name Administrative Support Below Grade 8
Position Category Clinical Management Services
Complexity – some initiative and occasional judgment required
Impact – errors may cause minor damage; work requires regular attention to accuracy
Autonomy – performs work without constant supervision; expected results are specifically outlined
Communication – proactively provides information to others; ensures appropriate dissemination of information
Responsibility – assists others to ensure proper completion of work
Confidentiality – supervised when working with confidential information
Leadership – may provide periodic training or assistance to others
Work involves light exertion transporting materials or equipment but not for sustained time.
Little or no exposure to hazards such as dust, fumes, or extreme temperatures, airborne or blood borne pathogens, extreme temperatures, or allergens.
Ability to detect and translate speech or other communication required. May occasionally require the ability to distinguish colors and perceive relative distances between objects.
Occasional exposure to dust, noise, temperature changes, or contact with water or other liquids. Work is performed in an environmentally controlled environment.
Exhibit confidentiality, honesty, and actions that build trust and strengthen relationships. Listen to others and effectively communicate in a clear and concise manner through written and verbal communication. Demonstrate respect and commitment to the values of diversity and equity; seek out and incorporate diverse perspectives into decision making.
Excellence and Creativity
Exhibit initiative and ingenuity by taking ownership of tasks to proactively improve services, avoid problems, or develop opportunities. Generate novel and valuable ideas to impact institutional missions.
Identify and implement new methods to increase efficiency and quality.
Education and Development
Displays an ongoing commitment to continuous learning and self-improvement in one's area of responsibility. Actively seek out mentorship and learning opportunities that can be applied to current and future work activities. Develop and maintain professional affiliations. Participate in design, development, and/or evaluation of instructional materials, methods, courses, or programs.
Agility and Judgment
Remain flexible and versatile in rapidly changing environment and adapt quickly to changing circumstances. Change behavioral style or method of approach when necessary to achieve a goal. Make timely and sound decisions based on analysis of information, experience, and logic. Show reliability and accountability in the successful completion of all work.
Stewardship and Institutional Citizenship
Support transformational change to achieve institutional vision and strategies. Be an active and thoughtful participant in institutional initiatives, meetings, and committee work. Conserve resources and use in an efficient and cost effective manner across all institutional missions. Look for ways to improve and promote quality within area of influence.
Employment in this position may be contingent upon successfully completing a background and criminal history check, caregiver background check in accordance with the Wisconsin Caregiver Background Check
Law, physical examination, and / or driving record check.
Equal Opportunity Employer
The Medical College of Wisconsin is an affirmative action / equal opportunity employer and does not discriminate in hiring or employment on the basis of age, sex, race, color, religion, national origin, veteran status, disability, or sexual orientation.
Diversity and Inclusion
The Medical College of Wisconsin defines diversity as a commitment to recognizing and appreciating the variety of individual differences in an environment that promotes and celebrates individual and collective achievement. The diversity of MCW continues to be an important source of innovative ideas and creative accomplishments.
Employees that have access to MCW, affiliate, subsidiary, or student data or Protected Health Information
(PI), or research protected information are obligated to protect the confidentiality and proper use and access of this information in order to prevent loss, misuse, unauthorized access, unnecessary identification, or security breaches.
This job description is not an employment contract and the Medical College of Wisconsin may modify this document at any time. This document is intended to indicate the types of tasks and levels of skill, effort, and responsibility required by positions assigned this title. This information shall not be construed as a declaration of the specific duties and responsibilities of any particular position. It is not intended to limit or modify the right of any supervisor to assign, direct, and control the work of direct reports. The functions described are not to be interpreted as exclusive or all-inclusive of the various functions performed.