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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

• Greet the majority of visitors and patients, answer patient questions (via telephone/ in person) and give directional information.

• Effectively perform general clerical/administrative functions.

• Responsible for completing all steps of pre-registration/registration including patient interview, obtaining of signatures, providing Advance Directive information and distributes hospital specific literature.

• Pre-register and register all types of patients in multiple software systems.

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

• Maintains a professional demeanor in respect to patients and fellow employees.

• Ability to conduct financial collections and referrals for Financial Counseling. Ability to interview/prescreen self pay patients for possible financial assistance.

• Understands and complies with state and federal regulations as well as hospital, department and The Joint Commission policies and procedures related to patient access.

• Communicates with ancillary department, physicians, medical offices and within Patient Financial Services department.

• Conducts insurance verification tasks, pre-certification, or referral information from MD offices and/or insurance companies and authorization for elective and emergent patients.

• Ability to complete legal admission paperwork for psychiatric admits in accordance to DHS guidelines.

• Ensures accurate documentation of patient information.

• Responsible for checking and re-stocking supplies as needed.

• Participates in performance improvement activities for the department and organization.

• Adheres to all HIPAA guidelines and patient confidentiality policies.

• Completes annual educational and training requirements.

• Promotes the mission, vision, and goals of the organization and department.

• Performs other related work as required or requested.

Required Skills

1. Greets customers via telephone and determines nature of inquiry. Assists customers as necessary or refers them to internal or external sources.
2. Reviews and prepares past due accounts for collection. Ensures appropriate collection code used for such accounts. Maintains appropriate information needed for Medicare Bad Debt.
3. Assists patients with Financial Assistance applications and bank loans in a timely manner.
4. Researches all sources of potential financial assistance based on the specifics of each application. This may include Medicare, Medicaid, Financial Assistance, bank loans, COBRA, etc.
5. Requests and ensures the receipt of all pertinent information and supplemental documentation for the processing of financial assistance applications. Processes applications and monitors status to ensure an expedient decision involving each case, generating approval/denial letters.
6. Responds to all mail inquiries or requests in a timely manner.
7. Embodies the Memorial Health System 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. Sets up and reviews terms accounts according to policy and procedure.
2. Identifies self pay accounts at time of service, reviews for potential discounts and/or financial assistance and works with patient regarding payment options.
3. Corresponds with collection agencies regarding payments and other situations with accounts including: review and report of bad debt payments, and review and approval of suit authorizations.
4. Receives reviews and prepares accounts for bankruptcy purposes.
5. Monitors estates and files appropriate paper work when needed.
6. Reviews settlement offers and approves as appropriate.
7. Researches and resolves complex issues associated with patient accounts. As applicable, identifies, documents, and reports problematic trends to leadership.
8. Prepares and monitors monthly contract account.
9. Reviews nursing home correspondence for potential care overlap and the appropriateness of billing Medicare vs. the nursing facility. Ensuring proper billing of those accounts.
10. Identifies opportunities for account consolidation and takes the necessary steps to combine appropriate accounts.
11. Processes and track all payroll deduct activity
12. Processes credit card transaction payments on accounts.
13. 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

Greets patients/family members and offers assistance.

Completes all steps of pre-registration/registration including patient interview, collects insurance information, obtains photo identification and signatures for consent and distributes required patient information.

Coordinates accurate patient data collection to verify insurance eligibility and determines financial obligation, which may include collection of copayments.

Ensures compliance with all applicable HIPAA, Joint Commission, CDC, TMH and state and federal statues, providing required associated literature to patients at all PAS access points.

Responds to all emergency procedures.

Pushes/Assists patients in wheelchairs to the location of the service they need.

Communicates with co-workers and Manager on follow-up or concerns.

Demonstrates an ability to be flexible, organized and function well in a stressful situation.

Prioritizes the order of assisting patients based on the most critical patients first.

Assists with training of new personnel.

Maintains a professional demeanor at all times and demonstrates respect towards all patients, customers, peers and leadership.

Demonstrates an ability to be flexible, willing to work alternative shifts and cover call-ins as needed. May be required to work night or weekend shifts.

Demonstrates superior patient relations and interpersonal skills; demonstrates and appropriate level of mental and emotional tolerance and even temperament when dealing with staff, patients and general public, using tact, sensitivity and sound judgment; promotes a positive work environment and contributes to the overall team efforts of the department and organization.

Communicates the mission, vision and goals of the organization and department.

Demonstrates understanding of department policies and procedures.

Arranges self-directed learning and participates in continuing education on an annual basis.

Performs other job related duties and special projects as assigned by the Manager.

Required Skills

• Assists clinic in meeting goals related to quality and patient satisfaction by providing assistance, guidance, and direction to visitors and patients, in person and over the phone in a manner designed to yield a high level of patient satisfaction. Communicates patients needs through the tasking mechanism of the electronic health record. Accountable for achieving quality and patient satisfaction standards, including anticipating patient needs, grievances, and service recovery. 
• Schedules, reschedules and coordinates patient appointments. Reviews new patient requests.  Appropriately triages patients in urgent/emergency situations over phone or in person.  Able to operate multi-line phone and several phones efficiently and effectively.  Monitors patient flow through reception and works with team to minimize and notify patients of waits and delays.  Schedules interpreters if needed.
• Responsible for accurate registration of patient demographics and insurance. Utilizes a variety of external websites to confirm patient’s eligibility.  Determines appropriate copay, registration conversation, and insurance to bill based on appointment type.  Collects patient financial responsibility at the time of registration, including current and past due balances as needed.  Determine and provide age appropriate documentation to be completed by each patient.  Obtains and validates proper consent for patient treatment.   
• Assists clinic in meeting goals related to days in accounts receivable by working as part of a team responsible for several front-line billing aspects which may include but is not limited to, charge entry, charge submission, posting of payments, charge adjustments, and cash management, including bank deposits. Reviews and corrects demographics/insurance errors.  Assists in the clinic’s overall financial performance by monitoring accounts for bad debt balances, pre-payment requirements, patient portions at the time of service, and other old balances as applicable per clinic policy and procedures. 
• Responsible for several tasks related to the paper flow through office. Operates and maintains normal office machines with care and efficiency.  This may include, but is not limited to; working with incoming mail and faxed correspondence.  Assists in scanning correspondence and paper medical records and conducting quality assurance and quality audits, if requested. 
• Performs opening and close of day activities. This may include running various reports, cash management, and completing required work lists.
• Complies with all reimbursement rules and regulations, including Corporate Compliance and HIPAA. Applies the Minimum Necessary Standard when accessing protected health information.  Complies with established clinic policies and procedures and safety standards. 
• Manages task lists within the electronic health record.
• Assists clinic in meeting goals related to maintaining required government programs.
• Demonstrates support for and participates in accomplishing team goals and objectives.
• 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

• Responsible for completing all steps of pre-registration/registration including patient interview, collecting insurance information, obtaining picture identification and signatures for consents, providing Advance Directive information and distributing required patient information.
• Coordinate accurate patient data collection to verify insurance eligibility and determine financial obligation, which may include collection of copayments.
• Act as the communication hub for the hospital and demonstrate ability to function well in stressful situations. Monitor alarms and weather information. Call and process all codes as needed, and provide ongoing communication support during all code and disaster situations according to policies and procedures.
• Dispatch calls to all call staff including: Administrator on Call, nurse managers, house supervisors, surgery staff, respiratory therapy, and Plant Operations. Maintain records of current on call staff. Answer incoming calls to main hospital switchboard.
• Answer incoming calls for emergency line (56700) and process timely and correctly.
• Answer Stat Code and Rapid Response calls and process timely and correctly.
• Demonstrates an ability to be flexible, willing to work alternative shifts and cover call-ins as needed. May be required to work night or weekend shifts.
• Ensures compliance with all applicable HIPAA, Joint Commission, CDC, LMH, and state and federal statues, providing required associated literature to patients at all PAS access points.
• Coordinate security efforts for LMH through monitoring of security cameras and coordination of necessary actions with Plant Operations and/or police as needed, according to policy and procedure. Check in and log visitors entering the building after normal business hours.
• Responsible for patient flow in the ED, Diagnostic Center, Acute Care Unit, Obstetrics, and Special Procedures Area. Enters patient information into department whiteboards for tracking purposes.
• Monitors the patient volumes and flow throughout the day, adjusting Patient Access staff as needed. Work with staff and leaders in other areas in order to coordinate timely patient flow and services.
• Coordinate admission and patient placement in collaboration with the Case Management Team, Nursing Leadership, and Environmental services. Consult with other departments to provide for an interdisciplinary approach to patient’s needs.
• Conducts daily audits of accounts for quality assurance and performs necessary action to correct patient accounts. Distributes corrections as appropriate.
• Conduct insurance verification tasks, including referrals and authorization for elective and emergent patients. Check eligibility for Medicare, Medicaid, private insurance, etc.
• Demonstrates ability to be organized and perform daily tasks including reporting and closeout duties. Verify census information and patient data at the end of each day to ensure accurate patient accounts.
• Monitor the patient safe, recording and securing patient valuables as needed.
• Maintain petty cash and service recovery funds. Perform daily closing duties associated with the cash drawer.
• 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.
• Greet visitors and patients; answer patient questions (via telephone/ in person) and provide directional information as requested. Contribute to the positive customer relations and work to address any issues that arise when patients are present in order to maintain the positive experience.

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

• 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.