New

Patient Service Representative I

NorthShore University HealthSystem
paid time off, tuition reimbursement
United States, Illinois, Elmhurst
Nov 26, 2024
Position Highlights: Sign on bonus: (if applicable) Position: Location: [City, IL] Full Time/Part Time: [Full Time / Part Time] Hours: Monday-Friday, [hours and flexible work schedules] Required Travel: 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 and claim administrators. Records and electronically enters appropriate data. Analyzes available documentation and uses software or hospital resources to calculate and explain to patients an estimate of the expected charges for the services being provided, the amount expected from the insurance payer, and the amount owed by the patient or responsible party. Negotiates acceptable resolution of expected patient balance. Refers unsuccessful negotiations to the Financial Counselor. Provides information to patients to ensure they understand the hospital's billing and credit and collection policies that govern the revenue cycle and the processes that will be followed. Discusses self-pay financial responsibility payment options with the patient or responsible party including screening if patient is eligible for financial assistance, pre-approving or denying for charity care, entering coded data in the computer system, counseling patients on payment of remaining balance due and scanning financial assistance documents. Receives cash, check and credit card payments made at time of service as well as balances from prior visits. Post payments to appropriate account via computer system, issues receipt to patient/guarantor and maintains necessary records of transactions. Calculates adjustments and/or discounts of total charge amount and posts to account. Reconciles daily cash receipts with the day's cash activity, credit card journal report and computer cash drawer. Prepares daily deposits, forwards same to appropriate Patient Accounts personnel, maintains cash reserves accordingly and prepares daily cash activity report. Investigates discrepancies in daily cash closing process, corrects errors when possible or notifies supervisor of unresolved balancing issues. Responds to patients' request for information regarding billing and/or coordinates appropriate replies with financial counselors. Performs inpatient account corrections as requested by the Utilization Review Department to ensure accurate charges are posted to patients' bills prior to discharge. Performs daily charging of Observation hours for patients admitted to that status. Attends mandatory staff meetings, maintains familiarity with all memos, emails and pertinent information regarding policy and procedure updates retaining them for future reference, understands changes and incorporates them into personal routines. Communicates with Director or Supervisor any problems or questions pertaining to duties and established policies and procedures or, prior to implementation, to any revised protocols. Receives, properly responds to, or redirects telephone, electronic, and in-person inquiries from patients, their representative, payers, physicians and their staff, internal departments, and other persons and entities. Diffuses tense situations, problem solves, keeps situations from escalating, has a calming effect on all external and internal customers. Maintains confidentiality of patient's personal health information. \ Assists and contributes to the training of new employees. Performs related duties as assigned including, but not limited to, filing, distribution of questionnaires and medical records forms given by various departments for testing, distribution of pre-testing prep materials (e.g. specimen collection supplies and radiographic contrast) to patients, and distribution of CD formatted Radiology testing information for patient pickup, sorting mail, photocopying information, replenishing supplies and organizing/cleaning/disinfecting work area before shift completion, and performing next day set-up, including appointment confirmation, pre-registrations, payment requests, and chart prep. Accepts and completes special assignments, projects and other duties as required or assigned under the supervision of the Supervisor, Manager, or Director. Ability to maintain flexible work schedules including weekends, holidays, and multiple registration locations. What you will need: High School Required And Associates Degree Business Administration/Management Preferred 2 Years of registration, scheduling, patient accounts, cash collections or customer service experience in a healthcare setting Manual dexterity to operate various office machines Knowledge of health insurances, medical terminology and anatomy Strong data entry and keyboarding skills Knowledge of Microsoft Office Suite Bilingual skills A valid driver's license is required if the incumbent is selected to perform related duties at an off site location. If the incumbent uses their personal vehicle, the incumbent must maintain automobile liability coverage as required by law and evidence of such coverage may be requested. Required Benefits: Career Pathways to Promote Professional Growth and Development Various Medical, Dental, and Vision options Tuition Reimbursement Free Parking at designated locations Wellness Program Savings Plan Health Savings Account Options Retirement Options with Company Match Paid Time Off Community Involvement Opportunities