Scheduling Patient Access Associate 2
Location: Kankakee, IL
The Scheduling Patient Access Associate II must be competent in the following: registering, scheduling, insurance/Medicare/Medicaid compliance and strong customer service skills. The Patient Access Associate II must have the ability to work independently in a fast-paced environment. Interacting in a customer-focused and compassionate manner to ensure patients and their representatives' needs are met, and that they understand the hospital's revenue cycle expectations, including resolution through various payment options. The Patient Access Associate II will accurately collect, analyze and record demographic, insurance/financial and clinical data from multiple sources, and obtain other information and signatures necessary for registration and billing. Effectively screens for compliance with payer requirements for medical necessity and precertification and complete third-party eligibility and benefit verification to ensure accurate payment is secured.
- Job ID
- # of Openings
- PRN/TR (As Needed)
PART III: POSITION RESPONSIBILITIES (ESSENTIAL FUNCTIONS)
Accurately collects and analyzes all required demographic, insurance/financial, and clinical data necessary to schedule, pre-register, and register patients from all payor classes. Electronically records information on a timely basis. Follows EMTALA, HIPAA, payor and other applicable regulations and standards for registration. Reviews previously recorded information and analyzes active patient records to identify and resolve situations where care is different than originally identified, including reverification of payor information and medical necessity, revising and information all affected parties.
Assesses work flow and prioritizes departmental needs in relationship to own to ensure there is timely response to incoming calls and outstanding orders. Reviews call software consistently and makes necessary staffing adjustments to meet volumes.
Attends all mandatory continuing education and department meetings. Reviews email timely to keep abreast of current information.
Coordinates scheduled appointments effectively with regard to clinical urgency, procedural conflicts, physician and patient preference. Provides accurate and thorough documentation. Optimizes patient schedules for convenience and continuum of care. Routinely preregisters appointments at time of scheduling whenever possible to ensure patient satisfaction and prompt the benefit process.
Knowledgeable of all available resources and uses them effectively and independently. Maintains and organizes own reference materials, both financial and clinical.
Provides clear and complete preparation instructions for tests/procedures, and appropriately guides to applicable treatment site.
Provides greeting to help customer determine appropriate location and process to occur. Identifies self to all patients and their representatives and takes ownership of service encounter through completion, keeping patient and family informed of process and any delays. Listens and communicates effectively and compassionately with customers, ensures understanding and explores options.
Receives, properly responds to, or redirects telephone, electronic and in-person inquiries from patients, their representatives, payers, physicians and their staff, internal departments, and other entities. Accurately sorts and distributes incoming faxes and mail. Maintains confidentiality of personal health information working within the minimum necessary guidelines.
Reviews physician orders and other documentation against payer coverage and medical necessity criteria, uses screening software to determine whether services being provided meet third-party requirements for payment, contacts physicians as necessary for additional clinical information; informs physicians about payer requirements, initiates Medicare ABN processes as appropriate. Explains payer policies to patients and financial responsibility within the revenue cycle to assist in meeting other internal, regulatory and payor requirements. Documents financial expectations of payer and medical necessity verification. Refers appropriately to Patient Financial Services.Qualifications
Experience/Education Requirements:High School Diploma or equivalent.Computer literacy.Medical Terminology preferred.Office or other clerical experience preferred.Ability to read and write in English. Verbal skills required to interact on the telephone or in person in a courteous and respectful manner.Ability to do general arithmetic.Prior Call Center experience preferred.Prior knowledge of payer regulatory compliance and HIPAA Privacy and Security requirements.Detail oriented, committed to accuracy, and ability to problem solve.Understanding of the hospital revenue cycle.
License or Certification Requirements:None
Riverside Healthcare is revolutionizing care using leading-edge technology to diagnose and treat patients. We are ranked top in the nation for performance in neurosurgery, orthopedics, and heart surgery and have also been named one of the nation's 100 Top Hospitals® by Truven Health Analytics seven times. Riverside is nationally recognized for our specialty programs in obstetrics, trauma, oncology, rehabilitation, geriatrics, occupational health, psychiatric services, and treatment of alcohol and chemical dependency, as well as patient safety. We combine innovation and convenience at state-of-the-art facilities located in communities throughout the greater Kankakee area.
Riverside Medical Center proves that truly progressive medicine is being delivered in Chicago’s southwest suburbs and East Central Illinois. Join a team that is not only concerned with providing the best care possible but also with offering a work environment of advancement and growth. Riverside is a place that embraces a culture where opinions count and dedication is respected, where superior performance is rewarded with competitive salaries and excellent benefits.