Patient Access Representative II - Pulmonary Call Center

Position Highlights

Hourly Pay Range: $19.89 - $28.84 - The hourly pay rate offered is determined by a candidate's expertise and years of experience, among other factors.

Position:
Patient Access Representative II - Pulm Call Center

Location:

3040 Salt Creek Lane, AND 1614 W Central Rd, Arlington Heights, IL

Full-Time: 40 hours/weekly

Hours:

Monday – Friday, 8:30 AM - 5:00 PM.

Travel Required:

This role includes some travel to other locations and requires flexible hours to meet operational needs

• Performs complete and accurate registration and/or admission functions across multiple access services areas or sites to provide information to maximize reimbursement, and ensures timely and thorough information to all other providers and users of patient data.
• Verifies insurance requirements, obtains and understands insurance benefits.
• Collects non-covered fees.
• Registers and pre-registers outpatients in more than one clinical and diagnostic location within their primary area of responsibility and multiple access areas outside hiring location.
• Access areas include but may not be limited to Busse Center, Emergency/Admitting Department, Immediate Care Centers, Laboratory and Cancer Services.
• Interacts with patients and their representatives to collect and interpret all required demographic, insurance, financial, and clinical data necessary to facilitate patient check in and registration at point of service.
• Offers and/or schedules interpreter services for patients when necessary.
• Obtains and scans general consent for treatment, identification and insurance cards, Coordination of Benefits and other appropriate documents.
• Obtain and submit National Provider Identification (NPI) for providers not on staff ordering outpatient diagnostic tests.
• Interpret physician orders for completeness and compliance with regulatory agencies and NCH policies.
• Informs patients of registration processes and privacy notification, establishes financial responsibility to meet internal, regulatory or payer requirements.
• When applicable, completes the Medicare Secondary Payer (MSP) questionnaire and discusses potential deferral of services according to NCH policy.
• Initiates the Medicare Advance Beneficiary Notice (ABN), as appropriate, and explains payer policies to patients.
• Streamlines check in process for patient previously pre-registered and appropriately updates the account for changes identified upon arrival.
• Reviews physician’s orders for compliance with the Illinois Department of Public Health (IDPH), and the Center for Medicare & Medicaid Services (CMS) regulations and NCH and medical staff office policies.
• Ensures financial protocols and requirements are met.
• Refers patients to Financial Counselors for identification of financial assistance options.
• Identify clinical and financial criteria that require involvement of Case Management team or Financial Counseling.
• Collaborate with internal and external customers to provide timely resolution to third party payer requirements prior to date of service.
• Minimizes third party payer denials by verifying authorization of service prior to forwarding patients to service delivery areas.
• Maintains current knowledge of insurance requirements communicated by email, memorandum, educational matrices and in-services.
• Provides support to primary care practices and specialty care providers regarding utilization, authorization and referral activities.
• Communicates effectively with service delivery areas when unresolved financial issues impact appointment schedules.
• Proficient in the use of CPT and ICD codes, and utilizes online payer resources.
• Utilize estimator to determine financial responsibility and attempt to secure all financial responsibility prior to the date of service.
• Meet monthly cash collection goals as determined collaboratively by Department Director/Manager.
• Maintain registration accuracy by meeting or exceeding expectations with 97% or higher accuracy score.
• Resolve all work queues within Department standards determined time period to release bill holds to ensure timely reimbursement.
• Log cash collected receipts and maintain balanced cash at all times.
• Coordinates scheduling of service…