Care Coordination Assistant - Care Coordination - Days

What you will do

• Reviews and analyzes all required demographic, insurance/financial, and clinical data procured by patient intake and registration areas necessary to expedite payment on patient's accounts.
• Corrects information in the patients' medical record.
• Reviews new and previously recorded patient, insurance information. Electronically records all phone interactions and records resolution to follow-up items in a timely manner.
• Follows HIPAA, payer and other applicable regulations and standards for registration and billing. Performs pre-certification notification via telephone or electronically. Gathers and completes all required documentation for submission to insurance carriers per payer requirements.
• Enters patient procedure insurance and benefits eligibility information into the patient's medical record.
• Acts as a liaison between patients and insurance companies to pre-certify all inpatient, outpatient and observation procedures per insurance contract requirements. Notifies patients, Clinical Care Coordinator, Utilization Managers and ancillary departments regarding procedures that are potentially not covered. Researches pre-certification denials including missing authorization, patient pre-certification or referral documentation.
• Works on denied accounts with ancillary departments, and reimbursement specialists to gather required information due to incorrect ID, group numbers, invalid insurance or filing deadline expirations to fulfill secondary payer requirements and successfully process denied accounts.
• Identifies, researches, and secures authorization for unspecified, new or unlisted procedures to procure payment from insurance carriers. Documents number of days authorized by insurance carriers into the patient's medical record.
• Advises the Clinical Care Coordinators and Utilization Managers on managed care and insurance requirements, researches and researches issues to resolution with the Denials Team.
• Reviews physician's admission orders for compliance with the Illinois Department of Public Health (IDPH), and the Center for Medicare & Medicaid Services (CMS) regulations and NCH and medical staff office policies. .

What you will need:

• High School education required; Bachelors Degree preferred
• 2 Years of customer service work experience using computers required.
• 1 Year working in a healthcare setting (i.e. medical insurance or physician's office, etc.) required.
• Previous healthcare experience with regulatory compliance requirements, payer requirements, HIPAA privacy and security requirements, and general revenue cycle procedures preferred.
• Working knowledge of medical terminology or completion of a medical terminology course within the first three months of employment required.

Benefits:

• Eligibility for our Annual Incentive Plan, which offers the potential to earn a certain percentage amount of your base salary based on organizational performance. (For AIP eligible positions)
• Premium pay for eligible employees
• Career Pathways to Promote Professional Growth and Development
• Various Medical, Dental, Pet and Vision options
• Tuition Reimbursement
• Free Parking
• Wellness Program Savings Plan
• Health Savings Account Options
• Retirement Options with Company Match
• Paid Time Off and Holiday Pay
• Community Involvement Opportunities

Endeavor Health is a fully integrated healthcare delivery system committed to providing access to quality, vibrant, community-connected care, serving an area of more than 4.2 million residents across six northeast Illinois counties. Our more than 25,000 team members and more than 6,000 physicians aim to deliver transformative patient experiences and expert care close to home across more than 300 ambulatory locations and eight acute care hospitals - Edward (Naperville), Elmhurst, Evanston, Glenbrook (Glenview), Highland Park, Northwest Community (Arlington Heights) Skokie and Swedish (Chicago) - all recognized as Magnet hospitals for nursing excellence. For more information, visit www.endeavorhealth.org.

When you work for Endeavor Health, you will be part of an organization that encourages its employees to achieve career goals and maximize their professional potential.

Please explore our website (www.endeavorhealth.org) to better understand how Endeavor Health delivers on its mission to "help everyone in our communities be their best".

Endeavor Health is committed to working with and providing reasonable accommodation to individuals with disabilities. Please refer to the main career page for more information.

Diversity, equity and inclusion is at the core of who we are; being there for our patients and each other with compassion, respect and empathy. We believe that our strength resides in our differences and in connecting our best to provide community-connected healthcare for all.

EOE: Race/Color/Sex/Sexual Orientation/ Gender Identity/Religion/National Origin/Disability/Vets, VEVRRA Federal Contractor.