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Patient Access Representative II

2 months ago

Arlington Heights, Illinois, United States Northshore Full time
Job Summary

We are seeking a highly skilled Patient Access Representative II to join our team at Northwest Community Hospital. As a key member of our patient access department, you will be responsible for ensuring timely and accurate registration and scheduling of patients across multiple access services areas or sites.

Key Responsibilities
  • Perform complete and accurate registration and/or admission functions to provide information to maximize reimbursement.
  • Verify insurance requirements, obtain and understand insurance benefits, and collect non-covered fees.
  • Register and pre-register outpatients in multiple clinical and diagnostic locations within their primary area of responsibility and multiple access areas outside hiring location.
  • Interact 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.
  • Offer and/or schedule interpreter services for patients when necessary.
  • Obtain and scan 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.
  • Inform patients of registration processes and privacy notification, establish financial responsibility to meet internal, regulatory or payer requirements.
  • When applicable, complete the Medicare Secondary Payer (MSP) questionnaire and discuss potential deferral of services according to NCH policy.
  • Initiate the Medicare Advance Beneficiary Notice (ABN), as appropriate, and explain payer policies to patients.
  • Streamline check-in process for patients previously pre-registered and appropriately update the account for changes identified upon arrival.
  • Review 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.
  • Ensure financial protocols and requirements are met.
  • Refer 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.
  • Minimize third-party payer denials by verifying authorization of service prior to forwarding patients to service delivery areas.
  • Maintain current knowledge of insurance requirements communicated by email, memorandum, educational matrices and in-services.
  • Provide support to primary care practices and specialty care providers regarding utilization, authorization and referral activities.
  • Communicate effectively with service delivery areas when unresolved financial issues impact appointment schedules.
Requirements
  • Education: High school diploma required. College degree preferred.
  • Skills: Computer experience in a Windows environment required, Ability to functionally navigate multiple computer software systems with accurate keyboard skills following computer security protocols, The interpersonal communication skills necessary to interview and interact with customers and physicians and to project a professional and compassionate concierge style of service to patients, patient families, physician's and staff in person and on the telephone, Ability to work independently, exercising good judgment, and multi-task in a high-stress, fast-paced service environment with patients, patient's family and physician's, Detail-oriented with good analytical problem-solving skills to appropriately register patients and schedule patient procedures, Ability to operate routine office equipment (facsimile, copiers, plate production, scanners, printers), Ability to transact payments at time of service and maintain a cash drawer.
  • Experience: Minimum 2 years of customer service work experience required, Minimum of 1 year experience in a healthcare patient access department or hospital required, Previous healthcare experience with regulatory compliance requirements, payer requirements, HIPAA privacy and security requirements, and general revenue cycle procedures required, Epic Registration and/or Scheduling experience preferred.
  • Certification: Successful on-the-job completion of NCH Patient Access Specialist I competencies required.
Benefits
  • Career Pathways to Promote Professional Growth and Development
  • Various Medical, Dental, Pet and Vision options
  • Tuition Reimbursement
  • Free Parking
  • Wellness Program Savings Plan
  • Health Savings Account Options
  • Retirement Options with Company Match
  • Paid Time Off and Holiday Pay
  • Community Involvement Opportunities