Participant Engagement Specialist

Heartland Alliance Health • Chicago, IL

5h

About The Position

Summary :   The Participant Engagement Specialist will provide advanced customer service and engagement in reception and registration that enhance the participant experience and access to health care and other services within Heartland Alliance Health  while promoting excellence. The individual in this position will handle complex support services including, but not limited to, scheduling appointments, telephone operations, cash collection, auditing and reporting.  Individual accountabilities and work volume will be established through the development of annual Success Objectives, within the framework outlined below.

Requirements

• Education and/or Experience: High School Diploma and three years of related experience or Associates degree and one year of related experience.  Customer service experience required.
• Certificates, Licenses, Registrations:  Certificate in medical billing, medical office assistant, or a related field preferred.
• Computer Skills: Demonstrated computer proficiency, including knowledge or electronic medical record, word processing, spreadsheet and database software. Ability to use computers to tabulate and analyze data and electronic technology to receive, organize, prioritize, and transmit information.
• Language Skills:  Proficiency in a second language may be required.
• Other Qualifications: Ability to calmly and politely interact with others while addressing questions or concerns. Ability to manage multiple calls and prioritize urgent participant needs per protocol. Comprehension of and appropriate use of medical terminology, new developments in the health care delivery system, application of third party payer guidelines and concepts related to quality assurance measures.. General knowledge of medical record keeping and accounting, medical office practices, patient relations, and medical law, ethics and federal and state health care regulations.

Nice To Haves

• Prior experience in a healthcare related field or social service agency preferred.
• Certificate in medical billing, medical office assistant, or a related field preferred.

Responsibilities

• Greets, welcomes and engages participants into services at assigned locations, including health centers and outreach locations.
• Registers and assesses participants for program eligibility and screens participants for other social service needs or insurance benefits and entitlements services.
• Explains service offerings, answers questions, and makes appointments for all services, including but not limited to, medical, dental, and behavioral health care.
• Answers incoming and makes outgoing phone calls to schedule and remind participants of appointments while ensuring other calls are routed to appropriate person/program in a timely manner.
• Creates telephone note in electronic health record to alert Providers and/or Nurses of Participant requests for call-backs if not immediately available.
• Assists in telephone and other initiatives to increase participant engagement, improve participant experience and service delivery.
• Educates participants regarding patient responsibilities, services, sliding fee scale, patient rights, grievance policy, confidentiality and release of information.
• Generates and updates Program Participation Form and updates participant information as assigned.
• Maintains thorough understanding of medical coverage, managed care organizations, and third party liabilities, inclusive of Medicaid and Medicare.  Verifies and updates third party insurance.
• Maintains a strong familiarity with CPT codes and determines amount needed at co-pay based on service rendered. Accurately assesses, explains, and collects co-pays and issues receipts to participants.
• Generates daily and/or weekly reports of collection data.  Maintains accurate daily log of co-pay activity.
• Coordinates patient registration activities with Front Desk, Case Management and Billing Department.
• Possesses strong and effective communication skills and assists in coordination of interpretation services for participants as needed.
• Performs moderate to high volume of data entry. Assists with incoming and outgoing mail, and sorts, distributes and logs mail for participants accordingly.
• Conducts quality assurance activities to insure accuracy of program participant data and troubleshoots patient flow issues.
• Attends meetings and trainings as required.
• This position may require working at offsite locations, evening and Saturday hours.
• Other duties may be assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED