Patient Resource Specialist
Patient Resource Specialist
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Not Disclosed
Salary Not Disclosed
1 Vacancy
Job Description
Overview
The Patient Resource Specialist is responsible for creating an excellent impression of Lincoln Memorial Hospitals resources to patients families and other external customers over the phone or in person. They work collaboratively with patients providers colleagues and insurance companies to ensure that patient needs are met. The Patient Resource Specialist coordinates and participates in a variety of duties as part of the previsit process including patient identification preregistration preauthorization and appointment scheduling. They provide payment options collect balances due and initiate referrals for financial assistance per the Illinois Fair Patient Billing Act Illinois Uninsured Patient Discount Act and established procedures. The role also requires maintaining uptodate knowledge of Joint Commission standards Patient Rights and Responsibilities HIPAA compliance and health system policies.
Shift: Day
Hours: 8:00am 4:30pm
Weekends: As Needed
FTE: 1.0
Qualifications
Education
High school diploma or GED equivalent required.
Experience
Two (2) years of business office experience preferably in Patient Access billing collections insurance principles/practices or accounts receivable.
Previous experience in Patient Financial Services is highly desirable.
Three (3) years of customer service experience required.
Medical terminology medical office registration or billing experience strongly preferred.
CPSI/Evident systems experience preferred.
Other Knowledge/Skills/Abilities
Knowledge of medical terminology CPT HCPCS CCI Edits ICD10 CM/PCS coding Revenue Codes UB04 and EOB interpretation.
Proficient computer skills with the ability to enter retrieve and notate data in patient accounting and related systems.
Strong attention to detail critical thinking and problemsolving abilities.
Excellent verbal and written communication skills. Must maintain a calm professional demeanor in highstress situations.
Ability to work effectively with both internal and external customers.
Flexible and able to exercise sound judgment and initiative in fastpaced environments with competing priorities.
Proven ability to educate persuade and negotiate with patients and families.
Familiarity with state/federal regulations insurance guidelines and Joint Commission policies and procedures (to be obtained within one year of hire and maintained thereafter).
Responsibilities
Assist customers and others regarding patient account issues offering clear guidance and resolutions.
Educate patients and others on billing resolution private pay options collection efforts coordination of benefits thirdparty and governmental payment criteria insurance coverage payments and denials.
Serve as a liaison between external resources colleagues and patients to ensure smooth communication and assistance.
Demonstrate superior patient relations and interpersonal skills maintaining a calm demeanor while dealing with patients colleagues and the general public. Use tact sensitivity and sound judgment to promote a positive work environment.
Coordinate accurate patient data collection to verify insurance eligibility and determine financial obligations including collection of copayments and deductibles.
Effectively negotiate with patients and families to explain collect and record patient payments and/or deposits ensuring all information is entered accurately into electronic payment and patient accounting systems.
Process and reconcile cash checks credit card transactions and bank loans as appropriate maintaining accuracy and security in the cash drawer.
Prepare bank deposits for pickup in accordance with departmental procedures.
Effectively triage document and initiate referrals for financial assistance completing necessary paperwork or applications with MHS Patient Financial Services.
Review and combine multiple financial accounts for individual patients. Explain available payment options and establish appropriate payment plans with patients or responsible parties per departmental guidelines.
Research and resolve complex issues related to patient accounts identifying and documenting problematic trends for management.
Record all customer visits accurately ensuring proactive discussion of all the patients accounts noting and logging accounts according to departmental procedures.
Document all collection activities thoroughly and send daily payment reconciliation reports to the appropriate teams within the MHS Finance Department.
Identify prioritize and resolve problematic accounts by reviewing investigating and verifying patient eligibility for payer sources and/or financial assistance.
Coordinate with various departments such as MHS Patient Financial Services Patient Access Case Management Scheduling and clinical departments to ensure accurate financial documentation and a consistent interdisciplinary approach.
Work with clinical departments to obtain insurance authorizations verifications and precertifications for outpatient services as needed.
Build strong relationships with assigned business units hospital departments or provider offices identifying and addressing trends in payment issues educating and communicating with internal and external customers as appropriate.
Complete all steps of preregistration and registration verifying patient identity and demographic information ensuring insurance eligibility and providing necessary patient information including Advance Directive information.
Orients and crosstrains other team members as directed by management. Understands and utilizes all relevant computer systems related to job functions.
May assist other areas within the unit or department during special needs or staff absences.
Coordinate patient or family requests for records with Health Information Management (HIM).
Perform other related work as required or requested.
Required Experience:
Unclear Seniority
Employment Type
Full-Time
