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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

• Greet and assist the majority of visitors and patients, answering questions via telephone or in person, and providing directional information.
• Effectively perform general clerical and administrative functions.
• Complete all steps of pre-registration and registration, including patient interviews, obtaining signatures, providing Advance Directive information, and distributing hospital-specific literature.
• Pre-register and register all types of patients across multiple software systems.
• Demonstrate flexibility, organization, and the ability to function well in stressful situations while maintaining a professional demeanor with patients and colleagues.
• Conduct financial collections and referrals for Financial Counseling, interviewing and prescreening self-pay patients for potential financial assistance.
• Understand and comply with state and federal regulations, as well as hospital, department, and The Joint Commission policies related to patient access.
• Communicate effectively with ancillary departments, physicians, medical offices, and within the Patient Financial Services department.
• Conduct insurance verification tasks, pre-certification, and referral information from MD offices and insurance companies for both elective and emergent patients.
• Complete legal admission paperwork for psychiatric admissions in accordance with DHS guidelines.
• Ensure accurate documentation of patient information.
• Check and restock supplies as needed.
• Participate in performance improvement activities for the department and organization.
• Adhere to all HIPAA guidelines and maintain patient confidentiality.
• Complete annual educational and training requirements.
• Promote the mission, vision, and goals of the organization and department.
• Perform other related duties as required or requested.

Required Skills

• Greet and assist the majority of visitors and patients, answering questions via telephone or in person, and providing directional information.
• Effectively perform general clerical and administrative functions.
• Complete all steps of pre-registration and registration, including patient interviews, obtaining signatures, providing Advance Directive information, and distributing hospital-specific literature.
• Pre-register and register all types of patients across multiple software systems.
• Demonstrate flexibility, organization, and the ability to function well in stressful situations while maintaining a professional demeanor with patients and colleagues.
• Conduct financial collections and referrals for Financial Counseling, interviewing and prescreening self-pay patients for potential financial assistance.
• Understand and comply with state and federal regulations, as well as hospital, department, and The Joint Commission policies related to patient access.
• Communicate effectively with ancillary departments, physicians, medical offices, and within the Patient Financial Services department.
• Conduct insurance verification tasks, pre-certification, and referral information from MD offices and insurance companies for both elective and emergent patients.
• Complete legal admission paperwork for psychiatric admissions in accordance with DHS guidelines.
• Ensure accurate documentation of patient information.
• Check and restock supplies as needed.
• Participate in performance improvement activities for the department and organization.
• Adhere to all HIPAA guidelines and maintain patient confidentiality.
• Complete annual educational and training requirements.
• Promote the mission, vision, and goals of the organization and department.
• Perform other related duties 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

• Pre-Registration/Registration: Completes all steps of pre-registration/registration, verifies patient identity and demographic information, and captures health insurance benefit eligibility based on contract/regulatory requirements. Ensures proper consent for patient treatment is obtained.

• Mammography Scheduling: Schedules patients for Mammography procedures according to established protocols, ensuring proper modality, location, insurance requirements, patient preferences, and urgency.

• Billing and Payment Education: Educates patients on billing resolution, private pay options, collection efforts, coordination of benefits, third-party payments, insurance coverage, payments, and denials. Acts as a liaison between external resources and patients for issues requiring SMH involvement.

• Coordination of Financial Documentation: Works with Patient Financial Services, Utilization Management, physicians, and medical offices to maintain consistent financial documentation and interdisciplinary collaboration.

• Regulatory Compliance: Adheres to CMS Conditions of Participation and Section 1154(e) of the Social Security Act, ensuring proper patient signature acquisition. Verifies medical necessity and obtains signatures on Advance Beneficiary Notice of non-coverage (ABN) per CMS regulations.

• Co-Pay and Deposit Collection: Negotiates with patients and families to collect co-pays and/or deposits at the point of service, supporting POS collection goals.

• Financial Assistance Referrals: Triage, document, and refer patients to Medicaid vendors or financial assistance per the Illinois Fair Patient Billing Act and SMH procedures.

• Pre-Authorization/Pre-Certification: Identifies services requiring pre-authorization and works with physicians to meet eligibility requirements prior to service.

• Account Rejection Resolution: Analyzes and resolves rejected accounts from various hospital sources, ensuring verification of patient benefit eligibility and reimbursement from all payer sources, or suitability for financial assistance.

• Staff Training and Coverage: Orients and cross-trains others within the department and provides coverage during staff absences or special needs.

• HIPAA and Regulatory Compliance: Ensures compliance with all HIPAA, Joint Commission, CDC, SMH, and state and federal regulations. Educates patients about Advance Directives, Medicare D coverage, and the grievance process as appropriate.

• Knowledge Maintenance: Maintains up-to-date knowledge of applicable regulations, including the Illinois Fair Patient Billing Act and Illinois Uninsured Patient Discount Act, and completes all required annual organizational education.

• Legal Forms Compliance: Completes Illinois DHS legal forms for psychiatric admits in compliance with state and hospital policies, providing relevant education to patients and families.

• Flexible Work Settings: May rotate between different work settings such as patient registration, bedside registration, or SMH campus environments, and provide coverage for the SMH Financial Lobby Office.

• Productivity and Accuracy: Meets expectations for productivity, accuracy, and point of service collections. Attends quarterly department meetings unless otherwise approved.

• Additional Duties: Performs other related work as assigned.

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

• Customer Assistance:
  Assist patients and others with account issues by explaining and coordinating resolutions for billing, private pay options, collection efforts, coordination of benefits, and insurance coverage. Serve as a liaison between external resources and patients.

• Negotiation and Payment Collection:
  Negotiate with patients and families to explain, collect, and record payments and deposits using electronic payment systems. Process cash, checks, and credit card transactions as appropriate, ensuring the accuracy and security of the cash drawer and all cash equivalents.

• Cash Reconciliation:
  Reconcile cash accounts and resolve discrepancies. Prepare bank deposits for pickup and pursue account balances and payments in alignment with Patient Financial Services policies to maximize reimbursement.

• Relationship Building:
  Build strong working relationships with assigned business units, hospital departments, and provider offices. Identify trends in payment issues and communicate effectively with internal and external customers to educate and resolve problems.

• Complex Issue Resolution:
  Research and resolve complex issues related to patient accounts. Document and report problematic trends to management while collaborating with the patient financial services team to reduce outstanding accounts receivable balances.

• Account Management:
  Review and consolidate multiple accounts for individual patients. Explain available payment options and establish appropriate payment plans according to departmental policies and procedures.

• Documentation:
  Accurately record all customer visits to the Lobby Office, ensuring proactive discussion of all patient accounts. Log and batch accounts according to established procedures.

• Collection Activity Reporting:
  Thoroughly document all collection activities performed and complete/send daily account payment reconciliation reports to the appropriate teams within the Springfield Memorial Hospital Finance Department.

• Coordination:
  Coordinate with Springfield Memorial Hospital Patient Financial Services, Utilization Management, physicians, and medical offices to ensure consistent financial documentation and a cohesive approach to patient and organizational needs.

• Account Prioritization:
  Identify, prioritize, and resolve problematic accounts, verifying patient eligibility for potential payer sources and financial assistance.

• Benefit Eligibility Analysis:
  Analyze reports from various hospital sources to resolve benefit eligibility concerns and determine suitability for financial assistance. Initiate coverage acquisition as appropriate.

• Training and Cross-Training:
  Orient and cross-train others within the assigned area as directed by management. Understand the functionality of all related computer systems and assist other areas during times of need.

• Interpersonal Skills:
  Demonstrate superior patient relations and interpersonal skills, maintaining a calm and even temperament when interacting with staff, patients, and the public. Promote a positive work environment and contribute to the overall team efforts.

• Additional Duties:
  Perform other related duties as required or requested.

Required Skills

1. Utilizes customer service skills by providing support to patients, visitors, physicians, residents, medical students and staff. Greets, communicates effectively and registers/checks in outpatients in a positive, accurate and professional manner. Round regularly in the Imaging reception areas and act as a liaison between modalities and patients/families.

1. Answers phones utilizing proper phone etiquette to provide great customer service and meet customer needs.

1. Prepares digital images for continuation of care, medical records, and patients.

1. Ensures proper recording and transmission of appropriate patient and exam indicator information.
2. 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. Monitors the Radiation Information System (RIS) to ensure all operations are running and relay issues to the appropriate personnel.

1. Acts as liaison between patient floors, staff, outside physicians, Radiology Information System staff and Radiologists, and also between the radiologists and ordering clinician for reporting critical results in compliance with departmental policy.

1. Provides assistance to physicians, medical students and residents.

1. Provides assistance for and has functional knowledge of the web browser.

1. Reviews and performs account merges to maintain patient data accuracy.

1. 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. Acts as the administrative designee on behalf of and in cooperation with hospital administration.

• Responds to urgent administrative needs, complaint investigations, and any clinical or facility emergency.
• Serves as coordinator in emergency or disaster situation until relieved or assisted by the Administrator on call, Director of Nursing on call or other administrative staff members
• Performs services requested by the Administrator or Director on call. Communicates issues and works to resolve problems with other department managers.
• Interprets/clarifies goals, policies and procedures as necessary.
• Provides clinical expertise when necessary (i.e. transfer of patients requiring an RN, starting IVs and assisting staff with direct patient care).
• Provides support to patient/family/visitor/significant others, assisting them in the utilization of medical center resources as appropriate.

• Communicates regularly with Chief Nursing Officer and Executive Directors. Ensures the leadership is aware of events, staffing concerns and disciplinary situations.

1. Assumes administrative responsibility for patient care staffing on assigned shifts.

• Makes purposeful rounds on patient care units, Emergency Department, OR/PACU, and Patient Placement to gather information needed to make staffing decisions.
• Makes staffing adjustments to assure compliance with minimal staffing standards outlined in the Nursing Staffing Plan.
• Provides guidance/counsel in regard to staffing adjustments.
• Communicates staffing and administrative activities with nurse managers, directors of nursing, product line managers, and the chief nursing officer.

1. Provides guidance and coordination support to the healthcare team to optimize bed availability and achieve efficient patient throughput.

• Works closely with the patient care team (i.e. physicians, charge nurses, discharge planners, and patient care facilitators) to ensure timely coordination of daily discharges and transfers.
• Communicates with Environmental Services, Engineering/Facilities, Patient Placement and Patient Transport to identify, prioritize and resolve patient throughput bottlenecks.
• Rounds on patient care areas (inpatient units, ED, PACU) to identify delays in throughput and actively works with appropriate teams/departments to resolve delays in a timely manner.
• Responds to daily bed availability concerns as they arise.
• Proactively identifies patient throughput bottlenecks and works with clinical leaders to resolve them before they impact patient throughput.

1. Collaborates with nursing colleagues to enhance patient care, colleague growth and development, and customer satisfaction.

• Provides relevant feedback to assist nurse managers to support performance management.
• Utilize daily opportunities to assist staff to acquire additional clinical/communication/conflict resolution skills.
• Serves on committees/task forces as appropriate
• Acts as a positive role model/change agent.
• Demonstrates responsibility for own personal and professional growth.

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.