Business Service Representative

Overview

Performs registration functions in an effective and efficient manner to enhance coding, billing and case coordination efforts. Makes appropriate independent decisions that require assessment, reasoning and resolution regarding financial requirements to assure appropriate reimbursement for both the patient and the hospital. Performs prior authorizations for patients admission/surgeries to ensure reimbursement for services and participates in denials management activities. Interprets and applies hospital policies regarding financial resources and arrangements. Uses exquisite customer service skills when handling patient encounters/issues.
Qualifications

Certifications: , Education: , Work Experience:
Responsibilities

Accurately explains and completes registration and admitting forms. Obtains signatures from patients and policyholders. Explains and gets patient signatures for Consents, Assignment of Benefits, ABN's and Notice of Non Coverage forms.
Communicates detailed information clearly, concisely, actively, and in a timely manner.
Completes Medicare Secondary Payer (MSP) form in accordance with Medicare laws. Follows up on necessary information.
Interpretsinsurance coverage and benefits to patients.
Interviews and identifies patients with the potential for financial hardship and/or without third-party coverage and works with the patient for resolution. Provide essential information regarding Carle's Financial AssistanceProgram or payment arrangements
Obtains, updates and verifies patient demographics, insurance and co-pays and Primary Physicians.
Performs chart management duties proficiently by ordering, sending, and receiving charts when necessary. Creates new clinic charts and medical record numbers for new patients.
Performs insurance eligibility verification by using Nebo for payer information when possible. Understands terms and information listed on Nebo reports.
Performs prior authorizations for patients admission/surgeries to ensure reimbursement for services and participates in denials management activities.
Receives and posts co-payments as identified by third-party payers or patient insurance cards. Maintains cash drawers and balances according to procedures.
Registers all patients at each visit utilizing established policies for the capture of complete and up-to-date patient and insurance information.
Reviews, analyzes, and communicates registration errors to HRC management for quality improvement. Strives 5% or less error rate.
Scans all required patient information into software systems so that information is retrievable and accessible by hospital staff.
Understands, reviews and explains Patient Rights & Responsibilities, Notice of Privacy, and other pertinent admitting information to the patient and/or family member.
About Us

Find it here.

Discover the job, the career, the purpose you were meant for. At Carle Health, we're committed to fostering a workplace where every team member feels valued, respected and empowered, where passion and purpose come together to positively impact the lives of our patients and our communities. Find it all at Carle Health.

Our nearly 17,000 team members and providers work together to support patient care across central and southeastern Illinois. We've grown to include eight, award-winning hospitals and a multispecialty provider group with more than 1,500 doctors and advanced practice providers. We're developing the next generation of providers and healthcare professionals through Carle Illinois College of Medicine, the world's first engineering-based medical school, and Methodist College. Carle BroMenn Medical Center, Carle Foundation Hospital, Carle Health Methodist Hospital, Carle Health Proctor Hospital, Carle Health Pekin Hospital, and Carle Hoopeston Regional Health Center hold Magnet designations, the nation's highest honor for nursing care. We offer opportunities in several communities throughout central Illinois with potential for growth and life-long careers at Carle Health.

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. Carle Health participates in E-Verify and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee's Form I-9 to confirm work authorization. | For more information: View email address on click.appcast.io.

Compensation and Benefits

The compensation range for this position is $18per hour - $29.13per hour. This represents a good faith minimum and maximum range for the role at the time of posting by Carle Health. The actual compensation offered a candidate will be dependent on a variety of factors including, but not limited to, the candidate's experience, qualifications, location, training, licenses, shifts worked and compensation model.
Carle Health offers a comprehensive benefits package for team members and providers. To learn more visit careers.carlehealth.org/benefits.