Work With Us

Required Skills

1. Embodies the Memorial Health System Performance Excellence Standards of Safety, Quality, Integrity and Stewardship that support our mission, vision and values:

• SAFETY: Prevent Harm – I will put safety first in everything I do.  I will speak up, without fear, on matters of patient and colleague safety.  I will take action to create an environment of zero harm.

• QUALITY: Improve Outcomes –  I will continually advance my knowledge and skills.  I will seek out continuous improvement opportunities.  I will deliver evidence-based care that leads to excellence in outcomes.

• INTEGRITY: Show respect and Compassion  – I will respect others and show compassion.  I will behave honesty and ethically.  I will be accountable for my attitude, actions and health.

• STEWARDSHIP: Reduce Waste – I will use resources wisely and maintain financial stability.  I will work together to coordinate care and services across the health system.  I will promote healthier communities.

1. Retrieves records from various departments and performs extensive search of missing records from units.

1. Creates appropriate discharge register to verify receiving of record.

1. Prepares record for scanning according to HIM processing policy and procedures.

1. Processes electronic images in the electronic medical record system according to HIM processing policy and procedures.

1. Demonstrates an ability to be flexible, organized, and function well in stressful situations.

1. Communicates and coordinates with ancillary departments, physicians, medical offices and coding.

1. Provides customer service support to patients who call or present with questions and requests.

1. Performs appropriate quality reviews according to Joint Commission regulations.

1. Ensures patient information is released appropriately with accurate authorization to patients, other healthcare organizations for continuation of care, insurance providers to ensure payment, government agencies, and in response to legal requests.

1. Performs processes in accordance with CMS guidelines.

1. Adheres to the Statement of Values and Behavioral Standards.

1. Performs other related work as required or requested.

The intent of this job description is to provide a representative summary of the major duties and responsibilities performed by incumbents of this job.  Incumbents may be requested to perform tasks other than those specifically presented in this description.

Required Skills

• Completes all steps of pre-registration/registration; verifies patient identity and demographic information through appropriate tools. Identifies/captures appropriate health insurance benefit eligibility based on contract/regulatory differentiation. Facilitates appropriate billing of claims and hospital reimbursement. Obtains and validates proper consent for patient treatment.
• Schedules patients for Mammography procedures efficiently, effectively, and according to established protocol for modality, location, facility capabilities, insurance requirements, type of exam, patient preferences, and urgency.
• Educates patients/others regarding the resolution of billing, private pay options, collection efforts, coordination of benefits, third party and governmental payment criteria, insurance coverage, payments, and denials. May serve as a liaison between external resources and patients on issues requiring SMH involvement.
• Coordinates with SMH Patient Financial Services, Utilization Management, physicians, and medical offices to ensure consistent financial documentation across the enterprise, and an interdisciplinary approach to patient and organizational needs.
• Adheres to all CMS Conditions of Participation regulations and Section 1154(e) of the Social Security Act regarding delivery, explanation, and acquisition of patient/designated representative signatures.
• Verifies medical necessity, and obtains appropriate signature on Advance Beneficiary Notice of non-coverage (ABN) per CMS regulations at points of patient access.
• Negotiates with patients and families to collect patient co-pays and/or deposits at point of service. Supports Patient Access Services POS (Point of Service) collection goals as defined by Revenue Cycle leadership and best practice benchmarks.
• Triages, documents, and initiates referrals of patients to Medicaid vendor and/or for financial assistance, per the Illinois Fair Patient Billing Act, Illinois Uninsured Patient Discount Act, and established SMH procedures.
• Identifies/reviews services requiring pre-authorization/pre-certification by Medicare, Medicaid, Commercial, and Managed Care payers, to ensure provider eligibility requirements are met prior to receiving service. Utilizes appropriate technology and/or communicates with physician offices.
• Analyzes reports containing rejected accounts from a variety of hospital sources, including Non-Patient Access registration departments, and resolves toward verification of patient benefit eligibility, and subsequent reimbursement from all possible payer sources, or determines suitability for financial assistance.
• Orients and cross-trains others within assigned area of responsibility as directed and defined by management. May assist other areas within the unit or department, as necessary, during times of special needs or staff absences. May be required to work night or weekend shifts.
• Ensures compliance with all applicable HIPAA, Joint Commission, CDC, SMH, and state and federal statues, providing required associated literature to patients at all PAS access points. Educates patients regarding Advance Directives, Medicare D prescription coverage, SMH, Joint Commission, and Illinois Department of Public Health grievance process as appropriate.
• Maintains current knowledge of, and complies with, the Illinois Fair Patient Billing Act and Illinois Uninsured Patient Discount Act at all times.
• Completes Illinois DHS legal forms for psychiatric admits, in compliance with State of Illinois and SMH statues and guidelines. Provides relevant patient/family education.
• May rotate work settings, i.e., patient registration, bedside registration, or other SMH campus environments. May be required to provide coverage for the SMH Financial Lobby Office.
• Develops and maintains a comprehensive knowledge of the health system organization and its functions. Completes all assigned annual organizational education
• Meets expectations for productivity, accuracy, and point of service collections
• Attendance at quarterly department meetings is mandatory unless absence is approved by PAS management prior to the meeting date.
• Performs pre-registration functions as requested.
• Performs other related work as required or requested.

Required Skills

• Completes all steps of pre-registration/registration; verifies patient identity and demographic information through appropriate tools. Identifies/captures appropriate health insurance benefit eligibility based on contract/regulatory differentiation. Facilitates appropriate billing of claims and hospital reimbursement. Obtains and validates proper consent for patient treatment.
• Schedules patients for Mammography procedures efficiently, effectively, and according to established protocol for modality, location, facility capabilities, insurance requirements, type of exam, patient preferences, and urgency.
• Educates patients/others regarding the resolution of billing, private pay options, collection efforts, coordination of benefits, third party and governmental payment criteria, insurance coverage, payments, and denials. May serve as a liaison between external resources and patients on issues requiring SMH involvement.
• Coordinates with SMH Patient Financial Services, Utilization Management, physicians, and medical offices to ensure consistent financial documentation across the enterprise, and an interdisciplinary approach to patient and organizational needs.
• Adheres to all CMS Conditions of Participation regulations and Section 1154(e) of the Social Security Act regarding delivery, explanation, and acquisition of patient/designated representative signatures.
• Verifies medical necessity, and obtains appropriate signature on Advance Beneficiary Notice of non-coverage (ABN) per CMS regulations at points of patient access.
• Negotiates with patients and families to collect patient co-pays and/or deposits at point of service. Supports Patient Access Services POS (Point of Service) collection goals as defined by Revenue Cycle leadership and best practice benchmarks.
• Triages, documents, and initiates referrals of patients to Medicaid vendor and/or for financial assistance, per the Illinois Fair Patient Billing Act, Illinois Uninsured Patient Discount Act, and established SMH procedures.
• Identifies/reviews services requiring pre-authorization/pre-certification by Medicare, Medicaid, Commercial, and Managed Care payers, to ensure provider eligibility requirements are met prior to receiving service. Utilizes appropriate technology and/or communicates with physician offices.
• Analyzes reports containing rejected accounts from a variety of hospital sources, including Non-Patient Access registration departments, and resolves toward verification of patient benefit eligibility, and subsequent reimbursement from all possible payer sources, or determines suitability for financial assistance.
• Orients and cross-trains others within assigned area of responsibility as directed and defined by management. May assist other areas within the unit or department, as necessary, during times of special needs or staff absences. May be required to work night or weekend shifts.
• Ensures compliance with all applicable HIPAA, Joint Commission, CDC, SMH, and state and federal statues, providing required associated literature to patients at all PAS access points. Educates patients regarding Advance Directives, Medicare D prescription coverage, SMH, Joint Commission, and Illinois Department of Public Health grievance process as appropriate.
• Maintains current knowledge of, and complies with, the Illinois Fair Patient Billing Act and Illinois Uninsured Patient Discount Act at all times.
• Completes Illinois DHS legal forms for psychiatric admits, in compliance with State of Illinois and SMH statues and guidelines. Provides relevant patient/family education.
• May rotate work settings, i.e., patient registration, bedside registration, or other SMH campus environments. May be required to provide coverage for the SMH Financial Lobby Office.
• Develops and maintains a comprehensive knowledge of the health system organization and its functions. Completes all assigned annual organizational education
• Meets expectations for productivity, accuracy, and point of service collections
• Attendance at quarterly department meetings is mandatory unless absence is approved by PAS management prior to the meeting date.
• Performs pre-registration functions as requested.
• Performs other related work as required or requested.

Required Skills

• Completes all steps of pre-registration/registration; verifies patient identity and demographic information through appropriate tools. Identifies/captures appropriate health insurance benefit eligibility based on contract/regulatory differentiation. Facilitates appropriate billing of claims and hospital reimbursement. Obtains and validates proper consent for patient treatment.
• Schedules patients for Mammography procedures efficiently, effectively, and according to established protocol for modality, location, facility capabilities, insurance requirements, type of exam, patient preferences, and urgency.
• Educates patients/others regarding the resolution of billing, private pay options, collection efforts, coordination of benefits, third party and governmental payment criteria, insurance coverage, payments, and denials. May serve as a liaison between external resources and patients on issues requiring SMH involvement.
• Coordinates with SMH Patient Financial Services, Utilization Management, physicians, and medical offices to ensure consistent financial documentation across the enterprise, and an interdisciplinary approach to patient and organizational needs.
• Adheres to all CMS Conditions of Participation regulations and Section 1154(e) of the Social Security Act regarding delivery, explanation, and acquisition of patient/designated representative signatures.
• Verifies medical necessity, and obtains appropriate signature on Advance Beneficiary Notice of non-coverage (ABN) per CMS regulations at points of patient access.
• Negotiates with patients and families to collect patient co-pays and/or deposits at point of service. Supports Patient Access Services POS (Point of Service) collection goals as defined by Revenue Cycle leadership and best practice benchmarks.
• Triages, documents, and initiates referrals of patients to Medicaid vendor and/or for financial assistance, per the Illinois Fair Patient Billing Act, Illinois Uninsured Patient Discount Act, and established SMH procedures.
• Identifies/reviews services requiring pre-authorization/pre-certification by Medicare, Medicaid, Commercial, and Managed Care payers, to ensure provider eligibility requirements are met prior to receiving service. Utilizes appropriate technology and/or communicates with physician offices.
• Analyzes reports containing rejected accounts from a variety of hospital sources, including Non-Patient Access registration departments, and resolves toward verification of patient benefit eligibility, and subsequent reimbursement from all possible payer sources, or determines suitability for financial assistance.
• Orients and cross-trains others within assigned area of responsibility as directed and defined by management. May assist other areas within the unit or department, as necessary, during times of special needs or staff absences. May be required to work night or weekend shifts.
• Ensures compliance with all applicable HIPAA, Joint Commission, CDC, SMH, and state and federal statues, providing required associated literature to patients at all PAS access points. Educates patients regarding Advance Directives, Medicare D prescription coverage, SMH, Joint Commission, and Illinois Department of Public Health grievance process as appropriate.
• Maintains current knowledge of, and complies with, the Illinois Fair Patient Billing Act and Illinois Uninsured Patient Discount Act at all times.
• Completes Illinois DHS legal forms for psychiatric admits, in compliance with State of Illinois and SMH statues and guidelines. Provides relevant patient/family education.
• May rotate work settings, i.e., patient registration, bedside registration, or other SMH campus environments. May be required to provide coverage for the SMH Financial Lobby Office.
• Develops and maintains a comprehensive knowledge of the health system organization and its functions. Completes all assigned annual organizational education
• Meets expectations for productivity, accuracy, and point of service collections
• Attendance at quarterly department meetings is mandatory unless absence is approved by PAS management prior to the meeting date.
• Performs pre-registration functions as requested.
• Performs other related work as required or requested.

Required Skills

• Plays a vital role in representing JMH in a positive, compassionate manner with professional communication, mannerism, and appearance
• Assist patients/visitors throughout the enterprise, providing telephone support, one-on-one assistance and way finding.
• Maintains cooperative and productive working relationships with all co-workers, physicians, management, and external customers to coordinate for optimum patient flow and throughput.

• Actively supports patient/family centered care by actions and attitude that demonstrates service excellence.

• Identifies customer service concerns and resolves and/or initiates service recovery.

• Accountable for Admissions and/or Registrations (Outpatient/ED/Pre), to ensure accurate demographic/financial data is properly obtained, entered, and documented into required system(s), which includes Bedside registrations, Pre-Registration, Point of Service Registrations, Bed Assignments and Facility to Facility Transfers, Initiates the Patient Revenue Cycle by proper identification, verification and entry of insurance and authorization information.

• Notifies and explains financial obligation to the patient/guarantor in a compassionate manner.

• Provides resources for financial assistance.

• Stays abreast of insurance and billing codes updates.

• Verifies Medicare Medical Necessity and issues ABNs for none covered services.

• Issues and explains insurance waivers, as necessary.

• Ensures outpatient physician orders are scanned and attached to the patient visit and tests are ordered via the order entry system accurately.

• Performs other related work as required or requested.

Required Skills

1. Coordinates the detailed investigation of workers’ compensation claims for all MH affiliate colleagues covered under the Illinois Risk Management Services or Illinois Compensation Trust.

             2. Gathers and analyzes data and develops and maintains current and accurate reports regarding                                 expenses and workers compensation injuries and reserves. Participates in gathering and presenting                         statistical data and recommendations to the Ergonomics Committee, Environment of Care, Finance,                         excess insurance carrier, actuarial audits, legal reviews and individual departments.

              3. Embodies the Memorial Health’s Performance Excellence Standards of Safety, Courtesy, Quality, and                         Efficiency that support our mission, vision and values:

• SAFETY: Prevent Harm – I put safety first in everything I do.  I take action to ensure the safety of others.

• COURTESY: Serve Others – I treat others with dignity and respect.  I project a professional image and positive attitude.

• QUALITY: Improve Outcomes – I continually advance my knowledge, skills and performance.  I work with others to achieve superior results.

• EFFICIENCY: Reduce Waste – I use time and resources wisely.  I prevent defects and delays.

1. Through a process of case management, acts as a liaison with nursing, physician, and therapy staff to facilitate problem solving and coordination of services, enhancing the efficiency and effectiveness of individualized treatment plans that promote early recovery and return to work. Coordinates care for Occupational Health Clinic/Visits. Schedules follow-up treatment and initiates referral process when indicated.

1. Utilizes effective communication to interact with colleagues , leaders and multi-disciplinary team members to facilitate colleague’s participation in treatment and discharge plan. Guides leaders on workers compensation process which includes, but is not limited to light duty accommodations, coding, PCR and leaves of absence. 

1. Assists HR leadership in monitoring effectiveness and efficiency of the Workers’ Compensation Program, participating in plans to facilitate program development in line with organization and department objectives.

1. Stays current with new developments in the field of rehabilitation, Ergonomics, Workers Compensation law, FMLA, ADA, HIPAA and best practices.

1. In coordination with Risk Management, Environment of Care & Ergonomics committees, and Safety departments, develops injury prevention strategies, promotes and deploys accident and injury prevention initiatives. Develops educational materials for leaders and colleagues and presents topics related to Workers’ Compensation as requested by individual departments and for purposes of organization-wide training.

1. In conjunction with IRMS, ICT and outside legal, reviews all legal cases, closure of pro settlement agreements as directed, and in consultation with leadership, makes recommendations for settlement of cases. Prepares case summaries and attends arbitration sessions as required.

1. Coordinates all aspects of the Return to Work (RTW) program for work injured colleagues, including communication to individual colleagues , managers, departments, tracking of restricted workdays, appropriate cost center accounting, closure with full RTW or referral to the Colleague Relations team for Americans with Disability Act considerations or the Leave Administration leave for leave requests.

1. Coordinates with Colleague Health for treatment, testing and counseling to colleagues following blood/body fluid exposure.

1. Updates and maintains the OSHA Log and accuracy of annual reporting for the Health System.

1. Acts as a liaison between outside insurance companies and MHS affiliate colleagues under the insured worker’s compensation programs to ensure timely reporting of injuries, early return to work, and prompt payment of medical bills. Maintains files on injured colleagues, monitors and communicates financial information to affiliates.

1. Works as a collaborative member of the Benefits department. This includes participating in the development and delivery of colleague benefits and wellness programs, Open Enrollment, Leave Management and more.

1. Assists in the administration of the absence management benefit plans including PTO, sick, and short term disability. Develops, reengineers and administers procedures in alignment with system capabilities and organization policies for administration of paid time off benefits.

1. Assists in administering and delivering the Wellness program. Assists in evaluating colleague wellness trends and partners with benefits staff to recommend changes to benefit programs based on the need.

1. Creates documentation for new processes and accurately updates existing documentation based on enhancements made to existing processes. Creates and monitors processes and supports continuous improvement efforts. 

1. Responsible for collaborating in and leading projects associated with leave of absence, wellness or benefit related plans.

1. Maintains confidentiality related to all information and records.

1. Maintains professional growth and development through continuing education, seminars, workshops and professional affiliations.

1. Performs other related work as required or requested.

The intent of this job description is to provide a representative summary of the major duties and responsibilities performed by incumbents of this job.  Incumbents may be requested to perform tasks other than those specifically presented in this description.