Patient Service Representative - Pediatrics - Chicago

Nevada System of Higher Education • Chicago, IL

2d • $18 - $27 • 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 understanding their physical and psychological needs and responding appropriately.
• Performs patient registration functions in a courteous and professional manner, including greeting and registering patients, collecting and analyzing required data, and interacting with patients, representatives, employers, and others in person or over the telephone.
• Analyzes and electronically records data and processes transactions into the hospital computer system, adhering to HIPAA, EMTALA, payer, and other applicable regulations and standards.
• Uses on-line physician ordering systems to retrieve and interpret physician orders, enters appropriate codes, and contacts physicians or staff for additional clinical information or clarification.
• Explains, secures, and witnesses all required signatures, and completes the Medicare Secondary Payer (MSP) questionnaire when applicable, updating 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, distributing them to internal and external parties.
• Coordinates daily in-patient admissions and bed placement with clinical or other staff, notifies appropriate nursing units of pending admissions, and maintains records for census control.
• Processes generated paperwork, matches registration information with standard admission forms, assembles charts, submits paperwork to appropriate units, 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, organizing and maintaining all data for prompt and accurate recovery.
• Performs daily midnight census verification through communication with in-patient units to receive written confirmation of admissions and reconcile census, following up with non-compliant units.
• Updates the hospital computer system to ensure a match of patient statistics between in-patient units and the system for correct room and board charges.
• Performs patient registration financial functions, including reviewing physician orders against insurance coverage and medical necessity criteria, using insurance screening software, and explaining insurance payer policies to patients.
• Obtains missing financial documentation for inpatients, initiates electronic inquiries to insurance payers, and records appropriate data.
• Analyzes documentation and uses software or hospital resources to calculate and explain estimated charges, insurance payer amounts, and patient balances, negotiating acceptable resolution of expected patient balances.
• Refers unsuccessful negotiations to the Financial Counselor and provides information to patients regarding billing and collection policies.
• Discusses self-pay financial responsibility payment options, screens for financial assistance eligibility, pre-approves or denies charity care, counsels patients on payment of remaining balances, and scans financial assistance documents.
• Receives cash, check, and credit card payments, posts payments to accounts, issues receipts, and maintains transaction records.
• Calculates and posts adjustments and/or discounts to the total charge amount.
• Reconciles daily cash receipts with cash activity, credit card journal report, and computer cash drawer, prepares daily deposits, and maintains cash reserves.
• Investigates discrepancies in the daily cash closing process and corrects errors or notifies supervisor of unresolved balancing issues.
• Responds to patients’ requests for billing information and 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, maintains familiarity with policy and procedure updates, and incorporates changes into routines.
• Communicates problems or questions regarding duties and policies to Director or Supervisor.
• Receives, responds to, or redirects inquiries from patients, representatives, payers, physicians, staff, internal departments, and other entities, diffusing tense situations and problem-solving.
• Maintains confidentiality of patient’s personal health information.
• Assists and contributes to the training of new employees.
• Performs related duties as assigned, including filing, distribution of questionnaires and forms, distribution of pre-testing materials, distribution of Radiology testing information, sorting mail, photocopying, replenishing supplies, organizing/cleaning/disinfecting 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

What This Job Offers

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