S hift: Full time, Days, 40 hrs/week

Reporting to the Point of Service Manager interacts with patients and/or their representatives to greet, pre-register and schedule appointments in order to ensure patient satisfaction, claim accuracy and reimbursement. Interviews patients to gather, interpret, and electronically record required demographic, financial and clinical data. Screens registration data for compliance with departmental and regulatory requirements, payer requirements for medical necessity and pre-certification, and completes third party eligibility and benefit verification. Coordinates patient needs and department resources to schedule patients for appropriate services. Develops a patient itinerary of coordinated or multiple appointments. Enters data into department specific and hospital systems and schedules patient tests and services in multiple hospital systems. Ensures customer satisfaction, staff and physician support, inventory control, report preparation, and accurate charge entry. Provides clerical and/or clinical support services such as preparing correspondence, contacting customers/patients and updating department records and charts.

1. Interacts with patients and their representatives to collect and interpret all required demographic, insurance and clinical data necessary to facilitate pre-registration of patients. Offers/schedules interpreter services when necessary and informs patients of registration processes and payer policies. Greets patients, reviews privacy notification/consent forms and scans identification and insurance cards and other applicable documents. Locates physician orders in the hospital fax management software system or interviews patients to interpret orders. Ensures orders are complete and in compliance with the Illinois Department of Public Health (IDPH), and the Center for Medicare & Medicaid Services (CMS) regulations and NCH and medical staff office policies. Identifies orders that require additional follow-up to meet financial and regulatory guidelines and may conduct research or contact Orders Management staff and/or Physician office to obtain compliant order. Attaches order to the medical record.

2. Schedules patient appointments, by telephone or face to face, in the hospital’s scheduling system for a wide range of outpatient procedures based on physicians orders. May inquire about medical conditions that could impact scheduling a specific test or procedure or may review a patient’s insurance eligibility for coverage variations based on location/provider of service. Explains any special patient preparation required per system instructions. Identifies and selects the appropriate test/procedure(s) and constructs appointments in the scheduling system by checking availability of department schedules and resources. Researches and develops a patient itinerary of coordinated or multiple appointments based on estimates of procedure times, availability of the patient and department resources and location of points of service. Reviews scheduled appointments for any identifiable patient flow issues to maximize NCH resources and meet patient service standards. Resolves scheduling conflicts and/or schedules urgent services. Assists in researching and resolving schedule conflicts between hospital departments and physicians on behalf of the patient.

3. Links patient registration and scheduling data from multiple systems to a patient case creating a permanent record for the patient in the appropriate system queue for use by clinical departments and other point of service staff. Upon validation of complete registration, activates patient accounts.

4. Manages all customer correspondence via phone, fax, electronic, and/or face-to-face interaction. Acts as a resource for all internal and external customer needs and inquiries. Records and relays all messages. Responds to general inquiries concerning the activities and operation of the department by relating or referring to established policies and procedures. Manages information concerning services, patient information/inquiries, purchasing, data processing and billing.

5. Enters accurate and complete departmental charges for services per policy. Accurately maintains monthly clinical and patient account statistics for Patient Financial Services bill preparation.

6. Reviews any previously recorded patient information for changes and electronically records all required information in multiple hospital information systems according to the Health Insurance Portability and Accountability Act (HIPAA), payer and other applicable regulations and standards for registration. Interprets payer regulations and agreements to determine if a patient’s case can be scheduled and discusses potential deferral of services following NCH policy and procedures when appropriate. Presents the patient with pre-registration face sheet documentation for review, obtains consents, signatures on Advanced Beneficiary Notice (ABN), obtains signatures for waivers of responsibility.

7. Performs insurance verification and medical necessity screening utilizing registration system software to determine whether services will meet internal, regulatory, and third-party payer requirements, and to establish financial accountability. Completes the Medicare Secondary Payer (MSP) questionnaire as appropriate.

8. Completes patient estimate of services, collects money due with current and outstanding balances, and resolves registration errors and insurance requirements prior to billing. Complies with NCH data integrity and quality standards related to accuracy, duplicate records, and phone efficiency set by the point of service department.

9. Completes a wide range of word processing, data entry and record keeping functions including preparing correspondence, forms, letters, tables, and charts. May perform data entry, scanning of department or patient records into system and maintains department specific logs, records, and statistics.

10. Performs various clerical functions, which may include arranging meetings and conferences, scheduling interviews/appointments, keeping schedules/calendars, operating office equipment and ordering department supplies. Take and prepare meeting minutes. Open, sort, and distribute mail. Copies and distributes various reports. Establishes, maintains, and revises record keeping and filing systems; classifies, sorts, copies, distributes and files correspondence, records, reports and other department specific records or documents. Other tasks as deemed appropriate and delegated by department Manager.

11. Contacts patients to confirm appointments, provide way-finding instructions, or communicate changes to previously scheduled services. Explains hospital credit and collection policies and payment options to patient/responsible party and refers patients to financial counseling when appropriate.

12. Adheres to all Northwest Community Hospital standards, policies, procedures, and reports compliance concerns to management staff.

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1. High school diploma or equivalent required, including coursework in keyboarding and office practices required. College degree preferred.

2. Minimum of 2 years customer service work experience required with a minimum of 1 year experience in healthcare patient accounting or a patient access department, physician’s office, medical clinic or hospital, or a call center/scheduling setting outside of healthcare required.

3. Computer experience in a windows environment, including Word, Excel, Outlook, and the ability to use a mouse required.

4. The analytical ability to prepare, process, and maintain documents and records; proficient keyboarding, computer, and secretarial skills. The ability to utilize a personal computer and operate office equipment. Ability to operate routine office equipment (facsimile, copiers, scanners, printers).

5. Ability to functionally navigate multiple computer software systems simultaneously with accurate keyboard skills following computer security protocols.

6. The interpersonal communication skills necessary to interview and interact with patients, physicians hospital staff and to project a professional and compassionate concierge style of service to patients, patient families, physician’s and staff in person and on the telephone with a multi-cultural patient population. Ability to facilitate and participate in discussions with the patient regarding propensity to pay, collections and deferral of services and conflict resolution.

7. Ability to work independently, exercising good judgment, and multi-task in a high stress, fast paced service environment.

8. Detail oriented with good analytical problem-solving skills to appropriately register patients and schedule patient procedures.

9. Ability to independently read, interpret and implement policies and procedures.