Patient Service Representative and Insurance Verifier, Rehab Services – Days, Evenings, Rotating

Nevada System of Higher Education•Arlington Heights, IL

1d•Onsite

About The Position

Under general supervision and according to established policies and procedures, the Patient Service Representative and Insurance Verifier is responsible for providing out-patient, rehabilitation patients with timely and accurate pre-registrations, registrations, order management, charge capture, and medical information systems. This role involves collecting, analyzing, and recording demographic, insurance/financial, and clinical data from multiple sources, and obtaining necessary information and signatures. The representative screens for third-party eligibility and enters medical necessity coding to ensure accurate payment. The position requires interacting in a customer-focused manner to meet the needs of patients and their families. Key duties include performing patient registration, processing transactions into the hospital computer system, adhering to HIPAA and payer regulations, utilizing online physician ordering systems, securing required signatures, scanning various documents, preparing forms and reports, escorting patients, managing patient charts, reconciling daily cash receipts, attending staff meetings, communicating issues to supervisors, responding to inquiries, diffusing tense situations, maintaining patient confidentiality, and performing administrative tasks such as filing, assisting with databases, and organizing the work area. The role also involves assisting with new employee training and undertaking special assignments.

Requirements

High School diploma or GED.
Valid driver’s license is required if the incumbent is selected to perform related duties at an off-site location.

Nice To Haves

Minimum of one to two years of registration, scheduling, or customer service experience in a healthcare setting.
Associates Degree.
Knowledge of health insurances, medical terminology and anatomy.
Strong data entry and keyboarding skills.
Knowledge of Microsoft Office Suite.

Responsibilities

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 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, payer and other applicable regulations and standards for registration.
Uses on-line physician ordering systems to retrieve and interpret physician orders/HMO authorizations for service and/or appointment schedules, enters appropriate codes into computer system.
Contacts physicians or physician office staff for additional clinical information.
Explains, secures and witnesses all required signatures.
Completes the Medicare Secondary Payer (MSP) questionnaire when applicable.
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, medical record forms, Medicare ABN and other special documents.
Produces and distributes these as appropriate.
Escorts patients to and from treatment areas as needed.
Processes generated paperwork.
Assembles and disassembles patient charts as required and prepares charts for Medical Records pick-up.
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.
Reconciles daily cash receipts with the day’s cash activity, credit card journal report and computer cash drawer.
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 Supervisor or Director 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.
Performs related duties as assigned including, but not limited to, filing, assisting patients to complete the computerized rehab outcome database, 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, and chart prep.
Assists and contributes to the training of new employees.
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 and multiple registration locations.