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Preaccess Specialist - CPRH

Carle Health
United States, Illinois, Peoria
221 Northeast Glen Oak Avenue (Show on map)
Jan 23, 2025
Overview

Performs pre-registrations for scheduled accounts via contact with patients, physicians, or appropriate information sources. Obtains insurance eligibility, benefits for inpatient and outpatient, scheduled and nonscheduled visits. Updates demographic and insurance information in system as needed. Initiates collection
process by creating and mailing estimates, contacting patients/representatives about date of service deductibles, coinsurance and copayments. Establishes financial arrangements with patients according to policy. Serves as a primary documentation source for access and billing staff.
Qualifications

License/Certifications:

Education:

Other Knowledge/Skills:

Responsibilities


  • Obtains daily work through systems' work queues and reports.
  • Completes eligibility check and obtain benefits though electronic means or via phone contact with insurance carriers or other agencies.
  • Contacts patients/families/physicians to obtain additional demographic/insurance information and update in computer system if needed in order to proceed with verification process.
  • Demonstrates subject matter expertise with insurance requirements across multiple affiliates.
  • Accurately and thoroughly collects, analyzes and records demographic, insurance/financial and data in computer system.
  • Ensures information source is appropriate.
  • Explain benefits and request copay, coinsurance and portion of deductible including any financial liability.
  • Follows department policy for payment or nonpayment responses.
  • Requests patient to bring required documents on day of service, i.e., physician orders, insurance

    cards, claim forms, liability information, photo ID, etc.
  • Documents in system the need for front-end Patient Access Associate to collect at time of service if unable any copay or deductible or financial liability that could not be collected during the preregistration process.
  • Identifies patients in financial hardship and refer to Patient Financial Coordinators for charity/financial assistance.
  • Refers to Patient Financial Services any patients requiring payment plans.
  • Completes all registration checklist, warnings, etc.
  • Documents on accounts using hospital account note with activity comments to ensure easy account follow up.
  • Follows EMTALA, HIPAA, payer and other regulations and standards


Register outpatients and emergency department patients when necessary
About Us

Find it here.

Discover the job, the career, the purpose you were meant for. The supportive and inclusive team where you can thrive. The place where growth meets balance - and opportunities meet flexibility. Find it all at Carle Health.

Based in Urbana, IL, Carle Health is a healthcare system with nearly 16,600 team members in its eight hospitals, physician groups and a variety of healthcare businesses. 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. The system includes Methodist College and Carle Illinois College of Medicine, the world's first engineering-based medical school, and Health Alliance. 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: human.resources@carle.com.


Compensation and Benefits

The compensation range for this position is $16.98per hour - $27.51per 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.
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