Patient Schedule Representative I

at NorthShore University Health System in Chicago, Illinois, United States

Job Description

A Brief Overview:
Under general supervision and according to established policies and procedures, responsible for providing in-patient, out-patient, emergency room, immediate care and same day surgery patients with timely and accurate pre-registrations, registrations, order management, charge capture, cash collection functions and medical information systems. Collects, analyzes and records demographic, insurance/financial and clinical data from multiple sources and obtains other information and signatures necessary for the above processes. Screens for third-party eligibility and enters medical necessity coding to ensure accurate payment is secured. Interacts in a customer-focused manner to ensure the needs of patients and their families are met and that they understand the hospital's revenue cycle expectations, including resolution of personal liabilities through various payment options.

What you will do:
Demonstrates the knowledge and skills necessary to provide care appropriate to the age of patients served. This includes knowledge of the physical and psychological needs of patients served and the ability to respond appropriately to those needs.
Performs patient registration functions in a courteous and professional manner according to established policies and procedures:
Greets and registers patients.
Collects and analyzes all required data necessary to pre-register and register patients. Interacts with patients, their representatives, employers and others in person, including in treatment and hospital inpatient rooms, or over the telephone, and reviews new and previously recorded information. Analyzes and electronically records data and processes transactions into the hospital computer system. Follows HIPAA, EMTALA, payer and other applicable regulations and standards for registration.
Uses on-line physician ordering systems to retrieve and interpret physician orders for service and/or appointment schedules, enters appropriate accommodation and test codes into computer system. Contacts physicians or physician office staff for additional clinical information and clarifying or obtaining orders for inpatient admission and outpatient testing.
Explains, secures and witnesses all required signatures. Completes the Medicare Secondary Payer (MSP) questionnaire when applicable.
Updates the billing information in the accounts according to data collected in the questionnaire.
Scans insurance cards, IDs, insurance referrals and authorizations, consents, physician orders, HIPAA, Medicare Advance Beneficiary Notice, and other regulatory paperwork into hospital's document imaging system. Prepares required forms, documents, and reports including labels, identification bands, medical record forms, Medicare ABN, payment promissory notes, and other special documents. Produces and distributes these to both internal and external parties.
Coordinates daily in-patient admissions and bed placement with clinical or other staff according to special medical needs. Notifies appropriate nursing units of pending admissions. Maintains records for census control and expeditiously enters all admissions, discharges and transfers.
Processes generated paperwork. Matches registration information with standard admission forms. Assembles charts as required, submits paperwork to appropriate nursing unit or department, and disassembles patient charts. Scans medical records in accordance with the guidelines set by Medical Records Department.
Prepares and maintains logs and reports of various data of patient registrations.
Converts to manual processes and procedures for scheduled and unscheduled computer system downtimes, organizes and maintains all data to ensure a prompt and accurate recovery.
2.11 Performs daily midnight census verification through communications with each Edward and Linden Oaks in-patient unit to receive written confirmation of admissions and reconcile census. Follows up with non-compliant units to ensure data is received and reconciled. Updates hospital computer system to ensure a match of patient statistics between the in-patient units and the system to guarantee correct room and board charges are posted to accounts.
Performs patient registration financial functions in a courteous and professional manner according to established policies and procedures:
Reviews physician orders and other documentation against insurance payer coverage and medical necessity criteria. Uses insurance screening software to determine whether services being provided meet third-party requirements for payment. Explains insurance payer policies to patients. Obtains missing financial documentation for inpatients already admitted to ensure compliance with federal, state and hospital regulations and guidelines.
Initiates electronic inquiries to insurance payers... For full info follow application link.

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