Healthcare Registration Specialist PRN

3 weeks ago

Orland Park, Illinois, United States UChicago Medicine AdventHealth Great Lakes Full time
Overview:
The Per Diem Medical Registration Professional role at UChicago Medicine AdventHealth Great Lakes is a critical position in the patient financial services team. As a key member of the team, you will be responsible for ensuring that patients are appropriately registered for all service lines and performing eligibility verification, obtaining pre-cert and/or authorizations, making financial arrangements, requesting and receiving payments for services, and other duties as required.

The ideal candidate will have a high school degree or equivalent and one year or more of relevant healthcare experience, with prior collections experience preferred. Associate's degree and bilingual English/Spanish skills are also highly valued.

The estimated salary range for this position is between $43,000 and $55,000 per year, depending on skills and experience within this pay range.

Job Description:
The Per Diem Medical Registration Professional will ensure patients are appropriately registered for all service lines by performing eligibility verification, obtaining pre-cert and/or authorizations, making financial arrangements, requesting and receiving payments for services, and other duties as required. This role requires close working relationships with clinical partners to ensure continual open communication between clinical, ancillary, and patient access departments.

Responsibilities:
  • Proactively seeks assistance to improve any responsibilities assigned to their role
  • Accountable for maintaining a working relationship with clinical partners to ensure open communications between clinical, ancillary, and patient access departments, which enhances the patient experience
  • Provides timely and continual coverage of assigned work area in order to offer prompt patient service and availability for all clinical partner registration needs. Arranges relief coverage during extended time away from assigned registration area
  • Meets and exceeds productivity standards determined by department leadership
  • Contacts insurance companies by phone, fax, online portal, and other resources to obtain and verify insurance eligibility and benefits and determine extent of coverage within established timeframe before scheduled appointments and during or after care for unscheduled patients
  • Verifies medical necessity in accordance with Centers for Medicare & Medicaid Services (CMS) standards and communicates relevant coverage/eligibility information to the patient. Alerts physician offices to issues with verifying insurance
  • Obtains pre-authorizations from third-party payers in accordance with payer requirements and within established timeframe before scheduled appointments and during or after care for unscheduled patients. Accurately enters required authorization information in AdventHealth systems to include length of authorization, total number of visits, and/or units of medication
  • Obtains PCP referrals when applicable
  • Alerts physician offices to issues with obtaining pre-authorizations. Conducts diligent follow-up on missing or incomplete pre-authorizations with third-party payers to minimize authorization related denials through phone calls, emails, faxes, and payer websites, updating documentation as needed Submits notice of admissions when requested by facility
  • Corrects demographic, insurance, or authorization related errors and pre-bill edits
  • Meets or exceeds accuracy standards and ensures integrity of patient accounts by working error reports as requested by leadership and entering appropriate and accurate data Patient Data Collection:
  • Registers patients for all services (i.e. emergency room, outpatient, inpatient, observation, same day surgery, outpatient in a bed, etc.) and achieves the department specific goal for accuracy
  • Responsible for registering patients by obtaining critical demographic elements from patients (e.g., name, date of birth, etc.)
  • Confirms whether patients are insured and, if so, gathers details (e.g., insurer name, plan subscriber)
  • Performs Medicare compliance review on all applicable Medicare accounts in order to determine coverage. Identifies patients who may need Medicare Advance Beneficiary Notices of Noncoverage (ABNs). Issues ABN forms as needed
  • Performs eligibility check on all Medicare inpatients to determine HMO status and available days. Communicates any outstanding issues with Financial Counselors and/or case management staff
  • Completes Medicare Secondary Payer Questionnaire for Medicare beneficiaries
  • Properly identifies patients, ensures armband accuracy, inputs demographics information, and secures the required forms to ensure compliance with regulatory policies
  • Creates accurate estimates to maximize up-front cash collections and adds collections documentation where required
  • Calculates patients' co-pays, deductibles, and co-insurance. Provides patients with personalized estimates of their financial responsibility based on their insurance coverage or eligibility for government programs prior to service for both inpatient and outpatient services
  • Advises patients of expected costs and collects payments or makes appropriate payment agreements in adherence to the AdventHealth TOS Collection Policy
  • Attempts to collect patient cost-sharing amounts (e.g., co-pays, deductibles) and outstanding balances before service. Establishes payment plan arrangements for patients per established AdventHealth policy; clearly communicates due dates and amount of each installment. Collects payment plan installments, out-of-pocket costs, outstanding previous balances, and any other applicable amount from patients per policy. Informs patients of any convenient payment options (e.g., portal, mobile apps) and follows deferral procedure as required
  • Connects patients with financial counseling or Medicaid eligibility vendor as appropriate
  • Contacts patient to advise them of possible financial responsibility and connects them with a financial counselor if necessary
  • Performs cashiering functions such as collections and cash reconciliation with accuracy in support of the preestablished legal and financial guidelines of AdventHealth when required
  • Discusses financial arrangements for newborn(s), informs patient of the timeframe for enrolling a newborn in coverage, provides any documentation or guidance for the patient to enroll their child prior to or after the anticipated delivery date, and communicates appropriate information to registration staff as needed

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