Title: Coord, Quality Control (Admit) PD

Location: Laguna Hills

Department: Admitting

Status: Per-Diem

Shift: Days

Pay Rate: $32/hr

MemorialCare is a nonprofit integrated health system that includes four leading hospitals, award-winning medical groups – consisting of over 200 sites of care, and more than 2,000 physicians throughout Orange and Los Angeles Counties. We are committed to increasing access to patient-centric, affordable, and high-quality healthcare; your personal contributions are integral to MemorialCare's recognition as a market leader and innovator in value-based and other care models.

Across our family of medical centers, we support each one of our bright, talented employees in reaching the highest levels of professional development, contribution, collaboration, and accountability. Whatever your role and whatever expertise you bring, we are dedicated to helping you achieve your full potential in an environment of respect, innovation, and teamwork.

Position Summary

This position requires the full understanding and active participation in fulfilling the mission of Saddleback Medical Center. It is expected that the employee demonstrate behavior consistent with our core values: Integrity, Accountability, Best Practices, Compassion and Synergy. The employee shall support Saddleback Medical Center’s strategic plan and participate in and advocate performance improvement/patient safety activities.

The Quality Control Coordinator works under the direction of the Manager of the Admitting department and is responsible for reviewing admissions and registrations (Inpatients, ER visits, Outpatient Bedded, and Ancillary visits) to ensure account accuracy. The QC Coordinator must be able to multitask, with emphasis on detail essential, while utilizing daily system logs as a method of identifying and documenting registration errors. The QC Coordinator needs to communicate professionally and courteously while providing feedback, education, and training to the team. The QC Coordinator will correct and update patient demographics and financial information. Identifies trends, potential problems and conducts additional training when necessary. Must have a strong insurance verification background. They must be knowledgeable in coverages and the authorization process, including an understanding of insurance contracts. Must be able to prioritize job duties to ensure volumes are met. Must be familiar with the hospital’s EMR and system. The QC Coordinator promotes a positive team environment and maintains effective working relationships with co-workers, patients, and management.

Essential Functions and Responsibilities of the Job

1.               Ability to correct all registration errors and update information timely and accurately.

2.               Ability to calculate and collect any unmet deductible, copay, and coinsurance.

3.               Knowledge of Commercial plans, IPA’s, Medicare, Workers Comp, Medi-Cal, and Cal-Optima.

4.               Ability to interpret and advise patients of their financial responsibility (copay, coinsurance, deductible).

5.               Monitors and manages workqueues daily.

6.               Ability to role model outstanding customer service skills using “Simply Better” and AIDET principles.

7.               Ability to communicate effectively in written and verbal form.

8.               Serves as a knowledgeable resource to the staff.

9.               Educates and in-services staff on their errors.

10.           Ensures all registration forms are complete, signed and within the patient’s encounter in Epic. Enters notes in Epic as required.

11.           Ability to interact in a positive and constructive manner.

12.           Ability to be at work and be on time.

13.           Ability to follow company policies, procedures and directives.

14.           Ability to interact in a positive and constructive manner.

15.           Ability to prioritize and multitask.

*Placement in the pay range is based on multiple factors including, but not limited to, relevant years of experience and qualifications. In addition to base pay, there may be additional compensation available for this role, including but not limited to, shift differentials, extra shift incentives, and bonus opportunities. Health and wellness is our passion at MemorialCare—that includes taking good care of employees and their dependents. We offer high quality health insurance plan options, so you can select the best choice for your family. And there’s more...Check out our MemorialCare Benefits for more information about our Benefits and Rewards.

Experience

•                  2 or more years of experience in Admitting, insurance verification, medical business office or equivalent healthcare experience preferred.

•                  Strong customer service skills.

•                  Ability to communicate effectively and clearly in both written and verbal form.

•                  General knowledge of insurance payors: PPO, HMO, POS, EPO, Medicare, Medi-Cal, & Cal-Optima.

•                  Positive work ethic.

•                  Computer skills required including: electronic medical record and Microsoft Office.

•                  Knowledge of medical terminology.

Education

List the education licensures or certifications preferred or required to do the job.

•                  High School Graduate preferred

•                  Medical Terminology related course or certificate preferred