About City of Hope

City of Hope is an independent biomedical research and treatment organization for cancer, diabetes and other life-threatening diseases.

Founded in 1913, City of Hope is a leader in bone marrow transplantation and immunotherapy such as CAR T cell therapy. City of Hope’s translational research and personalized treatment protocols advance care throughout the world. Human synthetic insulin, monoclonal antibodies and numerous breakthrough cancer drugs are based on technology developed at the institution. AccessHope™, a subsidiary launched in 2019 serves employers and their health care partners by providing access to City of Hope’s specialized cancer expertise.

A National Cancer Institute-designated comprehensive cancer center and a founding member of the National Comprehensive Cancer Network, City of Hope is ranked among the nation’s “Best Hospitals” in cancer by U.S. News & World Report and received Magnet Recognition from the American Nurses Credentialing Center. Its main campus is located near Los Angeles, with additional locations throughout Southern California and in Arizona.

City of Hope’s commitment to Diversity, Equity and Inclusion

We believe diversity, equity and inclusion is key in serving our mission to provide compassionate patient care, drive innovative discovery, and advance vital education focused on eliminating cancer and diabetes in all of our communities. Our commitment to Diversity, Equity and Inclusion ensures we bring the full range of skills, perspectives, cultural backgrounds and experiences to our work -- and that our teams align with the people we serve in order to build trust and understanding. We are dedicated to fostering a community that embraces diversity - in ideas, backgrounds and perspectives; this is reflected in our work and represented in our people.

Position Summary

• Performs pre-registration functions prior to the patient admission (including but not limited to: obtains and/or verifies demographic, clinical, financial, insurance information, service eligibility, consent forms, and patient/guarantor information for pre-registered accounts).
• This also includes the reason for admission, attending, accepting, and clinical team for all inpatient admissions, along with accommodation level.
• Contacts patients, payers, or other departments to confirm and verify insurance and demographic information.
• Refers Patients to financial counselors to resolve insurance or payments issues.
• Identifies and resolves issues by working with patients, payors, and/or other COH departments and personnel in a single interaction with the patient. Identifies patients with "share of cost" or co-payments by performing pricing estimations and notifies patients of their expected patient liability and financial responsibility.
• Collects patient/guarantor liabilities and refers patients who are uninsured/underinsured to Financial Counselor for charity, financial assistance or governmental program screening and application processes.
• Notifies COH contracting department of inpatient transfers with a non-contracted insurance to prepare a Letter of Agreement (LOA) should patient to pursue inpatient services at COH and informs referring physician of approval status.
• Performs activities required to financial clearance for all inpatient types.
• Frequent communications will occur with patients/family members/guarantors, physicians/office staff, medical center and payors.
• Reviews admission orders for completeness and appropriateness based on established Medical Center criteria.

Key Responsibilities include:

Bed Management:

• Works closely with the nursing staff to ensure effective bed management.
• Performs of review of upcoming next day admission and ensures the appropriate notification are documented.
• Notifies patient and clinical team of delays in bed assignment. Escalates urgent cases to management and Nursing House Supervisor.

Registration/ Admission:

• Demonstrates an in-depth understanding of the flow of the patient registration process within the paper and electronic environments. Maintains department productivity, accuracy, and quality assurance standards while performing these duties. Ensures data is entered accurately for all patient demographic and insurance information.
• Ensures that financial protocols and requirements are met while providing access to service at COH facilities by reviewing account documentation.
• Maintains and applies current knowledge of insurance requirements when verifying eligibility and confirms authorization is secured prior to forwarding patients to service delivery areas; escalates unsecure financial accounts to management. Provides information and assistance to patients to ensure they understand the Financial Assistance policy and application process. Provides Financial Assistance applications to all uninsured patients.
• Completes all required legal documents and obtains and scans all other related documents.
• Performs cash collection functions, patient pricing estimates, admission, and inpatient transfer functions.
• Ensures patient safety using positive patient identification protocol.
• Completes all inpatient regulatory documents including MSPQ, Important Message from Medicare & Tricare. Completes notification of authorization to use Lifetime days for Medicare patients.
• Completes the Notice of Outpatient Observation Memorandum for Medicare and Non­ Medicare observation patients.
• Completes daily inpatient census reconciliation. Ensures inpatient account service designation and accommodation is correct and accurate throughout the inpatient stay.
• Ensures positive patient ID is completed and patient is arm banded/ escorted to room.
• Completes the monthly insurance verification for all admitted inpatients. Notifies Case Management of changes in insurance. Escalates to management, financial counselor, and case management patients without active insurance coverage.

Referral Coordination:

• Identifies insurance companies requiring Notice of Admission and obtains initial authorization for unscheduled inpatient admissions.
• Ensures the Notice of Admission is completed for all scheduled and unscheduled admissions. Completes Auth / Cert documentation indicating authorization/ reference number along with information for Case Management clinical review follow up is complete and accurate.

Inpatient Transfer Coordination:

• Coordinates the inpatient transfer of new and existing patient from referring facilities and physician including the pre-registration, authorization for transfer, clinical approval, transfer coordination and documentation in CRM.
• Notifies COH contracting department of inpatient transfers with a non-contracted insurance
• Coordinate a Letter of Agreement (LOA) and informs referring facility of approval status.
• Ensures the memorandum of transfer is obtained and complete prior to initiation of transfer.
• Ensures the appropriate outside studies including slides and imaging. Forwards outside studies to the appropriate department on inpatient transfers.
• Enters the orders for review of outside pathology and radiology studies.

Customer Service:

• Ensure a high level of customer service by greeting, being a resource to patients and visitors. Serve as a liaison between patients and support staff. Develop effective relationships with colleague, physicians, providers, leaders and other employees across the organization. Demonstrates genuine interest in helping our patients, providers and other employees by using excellent communication skills, being polite, friendly, patient and calm under pressure.
• Manage multiple, changing priorities in an effective and organized manner, under stressful demand while maintaining exceptional service. Maintain composure when dealing with difficult situations and responding professionally. Independently recognize a high priority situation, taking appropriate and immediate action.
• Effectively communicates with service delivery and other departments to resolve issues that impact patient care and escalating issues that cannot be resolved in accordance with departmental guidelines. Answering daily phone calls and pages from doctors, patients, employees, referring physician/ facilities, and insurance companies.

Quality Assurance:

• Maintains appropriate level of productivity and accuracy for work performed based on department standards. Maintains thorough knowledge of policies, procedures, and standard work within the department in order to successfully performance duties on a day-to-day basis.
• Maintaining Claim, DNB and Patient Work queues
• GIP Hospice (Hospital Account Record creation for billing and coding)

Follows established City of Hope and department policies, procedures, objectives, performance improvement, attendance, safety, environmental, and infection control guidelines, including adherence to the workplace Code of Conduct and Compliance Plan. Practices a high level of integrity and honesty in maintaining confidentiality.

Performs other related duties as assigned or requested.

Basic education, experience and skills required for consideration:

• High School or equivalent. Experience may substitute for minimum experience requirements
• Three years medical office clerical or customer service experience. Certification or degree may substitute for minimum experience requirements

Preferred education experience and skills:

• Medical terminology
• Admitting and insurance verification experience; Demonstrated ability / experience working with healthcare professionals

Additional Information:

• 12:30pm - 9:00pm shift, rotating holidays and weekend
• Part of a collective bargaining agreement
• The estimated pay scale represents the typical [salary/hourly] range City of Hope reasonably expects to pay for this position, with offers determined based on several factors which may include, but not be limited to, the candidate’s experience, expertise, skills, education, job scope, training, internal equity, geography/market, etc. This pay scale is subject to change from time to time.
• As a condition of employment, City of Hope requires staff to comply with all state and federal vaccination mandates.

City of Hope is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, sexual orientation, gender identity, age, status as a protected veteran, or status as a qualified individual with disability.