Patient Access Representative II

at NorthShore University Health System in Arlington Heights, Illinois, United States

Job Description

Patient Access Representative II
Position Highlights:
Position: Patient Access Representative II
Location: 800 W Central Road, Arlington Heights, IL
Full Time/Part Time: Part-Time (20 hours per week)
Hours: 3pm - 11:30pm , weekends 9am-5:30
Travel:N/A

What you will do:
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 areas for patients requiring multiple tests. Identify and assign electronic educational programs for scheduled services. Explains patient prep and way finding instructions to patient. Collaborates with physician offices to check-in appointments and schedule tests post-physician office visits at offsite NCH locations.

Electronically records all required and updated information on patient accounts in multiple hospital information systems according to Emergency Medical Treatment and Active Labor Act (EMTALA), the Health Insurance Portability and Accountability Act (HIPAA), payer, and other applicable regulations and standards.

Prepares all required patient registration forms, documents, charts and reports, labels, patient plates, identification bands, medical records forms, and other related documents for distribution to appropriate... For full info follow application link.

EOE: Race/Color/Sex/Sexual Orientation/ Gender Identity/Religion/National Origin/Disability/Vets, VEVRRA Federal Contractor.