Participant Engagement Specialist

Job Description

Job Description

Participant Engagement Specialist

Location varies : 4001 North Broadway, Chicago, IL 60613 and multiple locations (IN PERSON)

Summary : The Participant Engagement Specialist will provide advanced customer service and engagement at reception and registration, enhancing the participant experience and access to health care and other services within Heartland Alliance Health while promoting excellence. The individual in this position will handle complex support services including, but not limited to, scheduling appointments, telephone operations, cash collection, auditing and reporting. Individual accountabilities and work volume will be established through the development of annual Success Objectives, within the framework outlined below.

Essential Duties and Responsibilities:

• Greets, welcomes and engages participants into services at assigned locations, including health centers and outreach locations.
• Registers and assesses participants for program eligibility and screens participants for other social service needs or insurance benefits and entitlements services.
• Explains service offerings, answers questions, and makes appointments for all services, including but not limited to, medical, dental, and behavioral health care. 
• Answers incoming and makes outgoing phone calls to schedule and remind participants of appointments while ensuring other calls are routed to appropriate person/program in a timely manner. 
• Creates telephone note in electronic health record to alert Providers and/or Nurses of Participant requests for call-backs if not immediately available.
• Assists in telephone and other initiatives to increase participant engagement, improve participant experience and service delivery.
• Educates participants regarding patient responsibilities, services, sliding fee scale, patient rights, grievance policy, confidentiality and release of information.
• Generates and updates the Program Participation Form and updates participant information as assigned.
• Maintains a thorough understanding of medical coverage, managed care organizations, and third-party liabilities, including Medicaid and Medicare. Verifies and updates third-party insurance. 
• Maintains a strong familiarity with CPT codes and determines the amount needed at co-pay based on service rendered. Accurately assesses, explains, and collects co-pays and issues receipts to participants.
• Generates daily and/or weekly reports of collection data.  Maintains an accurate daily log of co-pay activity.
• Coordinates patient registration activities with Front Desk, Case Management, and Billing Department. 
• Possesses strong and effective communication skills and assists in the coordination of interpretation services for participants as needed. 
• Performs a moderate to high volume of data entry. Assists with incoming and outgoing mail, and sorts, distributes and logs mail for participants accordingly. 
• Conducts