at Carle in Urbana, Illinois, United States
Job Description
Preaccess Specialist – CPRH
+ Department: Patient Access – CPRH
+ Entity: Peoria Service Area
+ Job Category: Clerical/Admin
+ Employment Type: Full – Time
+ Job ID: 43214
+ Experience Required: 1 – 3 Years
+ Education Required: Not Indicated
+ Shift: Day
+ Location: Peoria, IL
+ Usual Schedule: M-F
+ On Call Requirements: NO
+ Work Location: Methodist Medical Center
+ Weekend Requirements: No
+ Holiday Requirements: Every Other
Email a Friend Save Save Apply Now Position Summary: Performs pre-registrations for scheduled accounts via contact with patients, physicians, or appropriate information sources. Obtains insurance eligibility, benefits for inpatient and outpatient, scheduled and nonscheduled visits. Updates demographic and insurance information in system as needed. Initiates collection process by creating and mailing estimates, contacting patients/representatives about date of service deductibles, coinsurance and copayments. Establishes financial arrangements with patients according to policy. Serves as a primary documentation source for access and billing staff. Qualifications: Previous customer service experience AND Experience interacting with patients and a working knowledge of third party payers and collections is preferred AND Prior experience with verification, and payer benefit and eligibility systems is preferred. Essential Functions: Obtains daily work through systems’ work queues and reports.+ Completes eligibility check and obtain benefits though electronic means or via phone contact with insurance carriers or other agencies.
+ Contacts patients/families/physicians to obtain additional demographic/insurance information and update in computer system if needed in order to proceed with verification process.
+ Demonstrates subject matter expertise with insurance requirements across multiple affiliates.
+ Accurately and thoroughly collects, analyzes and records demographic, insurance/financial and data in computer system.
+ Ensures information source is appropriate.
+ Explain benefits and request copay, coinsurance and portion of deductible including any financial liability.
+ Follows department policy for payment or nonpayment responses.
+ Requests patient to bring required documents on day of service, i.e., physician orders, insurance cards, claim forms, liability information, photo ID, etc.
+ Documents in system the need for front-end Patient Access Associate to collect at time of service if unable any copay or deductible or financial liability that could not be collected during the preregistration process.
+ Identifies patients in financial hardship and refer to Patient Financial Coordinators for charity/financial assistance.
+ Refers to Patient Financial Services any patients requiring payment plans.
+ Completes all registration checklist, warnings, etc.
+ Documents on accounts using hospital account note with activity comments to ensure easy account follow up.
+ Follows EMTALA, HIPAA, payer and other regulations and standards.
+ Register outpatients and emergency department patients when necessary
We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. Carle Health participates in E-Verify and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee’s Form I-9 to confirm work authorization. | For more information: human.resources@carle.com.Effective September 20, 2021, the COVID 19 vaccine is required for all new Carle Health team members. Requests for medical or religious exemption will be permitted.
