Healthcare isnt just changing. Its growing more complex every day. ICD-10 Coding replaces ICD-9. Affordable Care adds new challenges and financial constraints. Where does it all lead? Hospitals and Healthcare organizations continue to adapt, and we are vital part of their evolution. And thats what fueled these exciting new opportunities.
Who are we? Optum360. Were a dynamic new partnership formed by Dignity Health and Optum to combine our unique expertise. As part of the growing family of UnitedHealth Group, well leverage our compassion, our talent, our resources and experience to bring financial clarity and a full suite of Revenue Management services to Healthcare Providers, nationwide.
If youre looking for a better place to use your passion, your ideas and your desire to drive change, this is the place to be. Its an opportunity to do your lifes best work.
The MPTL Representative employs excellent customer service skills and is responsible for frequent communication with the facility based clinical team members and payor sources in partnership to deliver effective facility and patient bed management.
The MPTL Representative ensures timely, accurate and complete capture of all demographic and insurance information to ensure appropriate reimbursement for services rendered. In addition, the MPTL Representative is ultimately responsible for Admits, Transfers and Discharges meeting critical performance standards for timeliness.
Under the guidance and direction of the centralized patient access unit leadership and sensitive to the employee work life balance, will work a predefined schedule to support the operational and facility based needs of twenty four (24) seven (7) days a week operation. As patients require admissions, Transfers and or Discharges at the facility location. With the understanding to teamwork and support that may require modification to meet those needs.
Supports clinical bed management duties by ensuring system updates have been made in required IT systems for Admits, Transfers and Discharges, meeting 5 minute performance standard.
Corrects registration edits and demographic updates as required when changing patient status.
Conducts Insurance Eligibility / Benefit Verification via web-based tools and as necessary by phone.
Supports registration activities by printing necessary documentation (i.e., face sheets, patient armbands, and etc.), coordinating production with the facility caring for the patient.
Provides fax, phone, or electronic notification to payers of patient admissions and upgrades.
Identifies issues in need of escalation to corporate Financial Clearance staff and / or facility financial specialists (i.e., Financial Clearance and/or Financial Counseling staff).
Maintains up - to - date knowledge of specific registration requirements for all areas, including Inpatient and Outpatient Registration Services.
Ensures complete, accurate and timely entry of demographic information into the ADT system at the time of registration.
Communicates with the facility or providers when necessary to clarify or obtain additional patient information.
When necessary, escalates accounts to appropriate facility Patient Registration leadership staff.
Complies with HIPPA, PHI and its implications, ABN, MSP, EMTALA, etc. and other regulations which affect the registration process.
UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.
We are committed to introducing innovative approaches, products and services that can improve personal health and promote healthier populations in local communities. Our core capabilities... in clinical care resources, information and technology uniquely enable us to meet the evolving needs of a changing health care environment as millions more Americans enter a structured system of health benefits and we help build a stronger, higher quality health system that is sustainable for the long term.
We serve our clients and consumers through two distinct platforms:
?UnitedHealthcare, which provides health care coverage and benefits services.
?Optum, which provides information and technology-enabled health services.