Patient Service Representative - Pediatrics - Chicago

Endeavor Health•Chicago, IL

1d•Onsite

About The Position

Under general supervision and according to established policies and procedures, this role is 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. The position involves collecting, analyzing, and recording demographic, insurance/financial and clinical data from multiple sources, and obtaining other information and signatures necessary for these processes. It also includes screening for third-party eligibility and entering medical necessity coding to ensure accurate payment. The role requires interacting in a customer-focused manner to ensure patient and family needs are met and that they understand the hospital's revenue cycle expectations, including the resolution of personal liabilities through various payment options.

Requirements

High School Required
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.

Nice To Haves

Associates Degree Business Administration/Management Preferred

Responsibilities

Demonstrates the knowledge and skills necessary to provide care appropriate to the age of patients served, including physical and psychological needs.
Performs patient registration functions courteously and professionally, including greeting, collecting and analyzing required data, and processing 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, and enters appropriate codes into the computer system.
Contacts physicians or their staff for additional clinical information or to clarify/obtain orders.
Explains, secures, and witnesses all required signatures.
Completes the Medicare Secondary Payer (MSP) questionnaire when applicable and updates billing information accordingly.
Scans insurance cards, IDs, referrals, authorizations, consents, physician orders, HIPAA, Medicare Advance Beneficiary Notice, and other regulatory paperwork into the hospital’s document imaging system.
Prepares and produces required forms, documents, and reports, including labels, identification bands, medical record forms, Medicare ABN, and payment promissory notes.
Coordinates daily in-patient admissions and bed placement with clinical or other staff, and notifies appropriate nursing units of pending admissions.
Maintains records for census control and enters all admissions, discharges, and transfers.
Processes generated paperwork, matches registration information with standard admission forms, assembles charts, and disassembles patient charts.
Scans medical records in accordance with guidelines set by the Medical Records Department.
Prepares and maintains logs and reports of various patient registration data.
Converts to manual processes and procedures for scheduled and unscheduled computer system downtimes, ensuring prompt and accurate recovery.
Performs daily midnight census verification and reconciles census with in-patient units.
Updates the hospital computer system to ensure accurate room and board charges are posted.
Performs patient registration financial functions, including reviewing physician orders against insurance coverage and medical necessity criteria.
Uses insurance screening software to determine if services meet third-party payment requirements.
Explains insurance payer policies to patients and obtains missing financial documentation for inpatients.
Initiates electronic inquiries to insurance payers and claim administrators, and records appropriate data.
Calculates and explains to patients an estimate of expected charges, insurance payer amounts, and patient responsibility.
Negotiates acceptable resolution of expected patient balance and refers unsuccessful negotiations to the Financial Counselor.
Provides information to patients regarding the hospital’s billing and credit/collection policies.
Discusses self-pay financial responsibility payment options, screens for financial assistance eligibility, and counsels patients on payment of remaining balances.
Receives cash, check, and credit card payments, posts them to the appropriate account, and issues receipts.
Calculates adjustments and/or discounts and posts them to the account.
Reconciles daily cash receipts, prepares daily deposits, and maintains cash reserves.
Investigates discrepancies in the daily cash closing process and corrects errors or notifies supervisor.
Responds to patients’ requests for billing information or coordinates appropriate replies with financial counselors.
Performs inpatient account corrections as requested by the Utilization Review Department.
Performs daily charging of Observation hours for patients admitted to that status.
Attends mandatory staff meetings and stays informed of policy and procedure updates.
Communicates problems or questions regarding duties and policies to Director or Supervisor.
Receives, responds to, or redirects inquiries from patients, representatives, payers, physicians, staff, and other entities.
Diffuses tense situations, problem-solves, and maintains a calming effect on customers.
Maintains confidentiality of patient’s personal health information.
Assists and contributes to the training of new employees.
Performs related duties such as filing, distributing questionnaires and forms, providing pre-testing materials, sorting mail, photocopying, replenishing supplies, organizing/cleaning work area, and performing next day set-up.
Accepts and completes special assignments, projects, and other duties as required or assigned.
Maintains flexible work schedules including weekends, holidays, and multiple registration locations.

Benefits

Eligibility for our Annual Incentive Plan, which offers the potential to earn a certain percentage amount of your base salary based on organizational performance.
Premium pay such as shift, on call, holiday and more based on an employee’s job
Incentive pay for select positions
Opportunity for annual increases based on performance
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