Northwestern Medicine

Financial Planning and Analysis

• Resolve claim edits and report candidates for billing
• Submit compliant, clean, complete, accurate claims within filing deadlines
• Meet productivity, quality, error-ratio, target, and reporting standards
• Follow up on and collect third-party payer receivables
• Follow up on denials and appeals, perform root-cause analysis, and pursue payment resolution
• Correspond compliantly with third-party payers regarding outstanding accounts receivable
• Support operations for managed care, commercial, Medicare, Medicaid, replacement plans, workers’ compensation, corporate, research, and specialty accounts receivable
• Review work lists daily and complete accounts ready to be worked
• Apply government, commercial, and regulatory collection guidelines
• Recommend contractual or administrative write-offs with justification and documentation
• Maintain HIPAA privacy compliance
• Contribute to department accounts-receivable goals
• Identify customer, system, and process improvement opportunities
• Follow organizational, departmental, emergency preparedness, Joint Commission, and regulatory procedures
• Use hospital mainframe, reporting software, external applications, and assigned hardware; report problems appropriately
• Participate in software testing and verify field integrity
• Assist with special projects and other assigned duties
• Attend assigned and approved training and seminars
• Provide customer service and expertise to patients, guarantors, and internal/external contacts through oral and written communication

Financial Assessor, Patient Accounting

General

• Provide clinically expert virtual triage service
• Assess patients' presenting problems or chief complaints
• Use evidence-based triage protocols to identify acuity and develop care advice and next-step recommendations
• Serve as a liaison between patients and physicians
• Establish positive first impressions and act as a patient advocate
• Triage incoming telephone calls and electronic messages, prioritizing and resolving them and involving providers as appropriate
• Complete the communication cycle
• Develop, implement, and update individualized plans of care based on identified patient care, learning, and needs
• Ask key questions to assess patients' clinical conditions and adjust the approach as needed
• Document all communications in the electronic medical record
• Schedule patient visits with providers according to protocols
• Follow department triage protocols
• Assist with scheduling appointments with Northwestern Medicine providers
• Assist in orienting new staff members
• Assist with process improvement projects
• Participate in departmental quality improvement activities
• Use service recovery skills to resolve problems or service breakdowns

Triage RN, Part Time Nights

• Provide clinically expert virtual triage service
• Serve as a liaison between patients and physicians
• Assess presenting problems and chief complaints
• Use evidence-based triage protocols to identify acuity and provide care advice and next-step recommendations
• Triage incoming telephone calls and electronic messages
• Prioritize and resolve communications, involving providers as appropriate
• Develop, implement, and update individualized plans of care
• Ask key questions to assess patients’ clinical conditions
• Document communications in the electronic medical record
• Schedule patient visits with providers according to protocols
• Assist with scheduling appointments within Northwestern Medicine
• Assist in orienting new staff members
• Assist with process improvement projects
• Participate in departmental quality improvement activities
• Use service recovery skills to resolve problems and service breakdowns

Triage RN – Part Time Nights

Analyst

• Assign appropriate ICD-10-CM and CPT-4 codes to outpatient visit types
• Assign Evaluation and Management codes for physician encounters
• Thoroughly review medical records and documentation to code diagnoses, procedures, and evaluation and management services
• Collaborate with Patient Accounting, Registration, case managers, and clinical areas on coding reimbursement expertise
• Interpret health record documentation to report appropriate diagnoses and procedures
• Resolve NCCI, NCD/LCD, and other outpatient edit claim failures
• Meet established coding productivity and quality standards
• Perform other duties as assigned

Coding Analyst, Part Time – Day Shift

Patient Access Specialist

• Practice the Patients First philosophy and provide exceptional customer service
• Respond to patient questions and concerns and escalate extraordinary issues as necessary
• Maintain patient confidentiality in accordance with HIPAA regulations
• Identify and collect accurate patient demographic information
• Schedule and direct patients through Northwestern Medicine systems
• Reach out to patients to schedule appointments
• Perform medical necessity checks for scheduled services and communicate options when appointments fail
• Inform patients about issues securing financial accounts
• Complete out-of-pocket estimates upon request
• Provide training and education as needed
• Manage schedules and complete assignments on time
• Cross-train between departments to ensure coverage
• Participate in quality assurance reviews of patient data
• Resolve service breakdowns using service recovery skills
• Communicate physician referral, insurance referral, and consultation information
• Collect authorization numbers in appropriate systems
• Collaborate across units and departments and resolve operational issues
• Verify or print patient orders using online retrieval systems
• Verify insurance eligibility and benefit levels using online tools or phone
• Complete accurate handoff instructions and notes in Epic
• Run real-time eligibility checks and follow out-of-network policies
• Send descriptive, grammatically correct Epic messages and telephone encounters
• Prevent visit issues by verifying tests, preparation requirements, scheduling conflicts, time, location, and order retrieval
• Ensure complete registration data and update patient information
• Analyze account activity, identify problems, and initiate resolutions
• Suggest process improvements and participate in quality improvement activities
• Monitor registration, scheduling, and insurance verification against quality standards
• Act as a training resource for new staff and coworkers
• Perform other duties assigned by management

Medical Billing and Coding

• Assign appropriate ICD-10-CM and CPT-4 codes to outpatient visit types
• Review medical records and available documentation to code diagnoses and procedures
• Interpret health record documentation using anatomy, physiology, clinical disease process, pharmacology, and medical terminology knowledge
• Send physician queries for documentation clarification when required
• Follow Coding Clinic for HCPCS, CPT Assistant, coding conventions, and instructional notes with at least 95% accuracy
• Meet minimum coding productivity and quality standards, including 90% productivity and 95% quality
• Analyze system-related changes and participate in software modification testing
• Identify opportunities to enhance computer-assisted coding and notify the IT liaison of system issues
• Resolve NCCI edits using approved hospital modifiers
• Use 3M Encoder resources to ensure coding accuracy
• Articulate rationale for coding selections when needed
• Serve as a coding and reimbursement expert for complex outpatient encounters, including observation stays, same-day surgery, surgery center, and outpatient-in-a-bed cases

Outpatient Coder II, HB Coding

• Practice the Patients First philosophy and provide high standards of customer service
• Respond to patient questions and concerns, escalating extraordinary issues when necessary
• Maintain patient confidentiality under HIPAA regulations
• Identify and collect accurate patient demographic information
• Schedule and direct patients through Northwestern Medicine systems
• Contact patients to schedule appointments
• Perform medical necessity checks and communicate options when appointments fail
• Inform patients about issues securing financial accounts
• Complete out-of-pocket estimates when requested
• Provide training and education as needed
• Manage schedules and complete assignments on time
• Cross-train across departments to ensure coverage
• Participate in Quality Assurance reviews of patient data
• Resolve service breakdowns using service recovery skills
• Communicate physician referral, insurance referral, and consultation information
• Collect authorization numbers in appropriate systems
• Collaborate across units and departments to resolve operational issues
• Verify or print patient orders using online retrieval systems
• Verify insurance eligibility and benefit levels using online tools or by phone
• Complete handoff instructions and notes in Epic
• Run real-time eligibility checks and follow out-of-network policies
• Send accurate Epic Messages and telephone encounters
• Double-check tests, preparation requirements, scheduling conflicts, locations, and orders
• Prevent duplicate patient records and maintain complete registration data
• Analyze account activity and initiate appropriate resolutions
• Suggest and implement process improvements
• Monitor registration, scheduling, and insurance verification against quality standards
• Act as a training resource for new staff and coworkers

• Practice the Patients First philosophy and provide high standards of customer service
• Respond to patient questions and concerns, escalating extraordinary issues as necessary
• Maintain patient confidentiality under HIPAA regulations
• Identify and collect patient demographic information
• Schedule and direct patients through Northwestern Medicine systems
• Contact patients to schedule appointments
• Perform medical necessity checks and communicate options when appointments fail
• Inform patients about financial account issues and provide out-of-pocket estimates
• Provide training and education as needed
• Complete tasks and assignments on schedule
• Cross-train between departments to ensure coverage
• Participate in quality assurance reviews of patient data
• Resolve service breakdowns using service recovery skills
• Communicate physician referrals, insurance referrals, and consultation information
• Collect authorization numbers in appropriate systems
• Collaborate across units and departments to resolve operational issues
• Verify or print patient orders using online retrieval systems
• Verify insurance eligibility and benefit levels using online tools or telephone
• Document accurate handoff instructions and notes in Epic
• Run real-time eligibility checks and follow out-of-network policies
• Prevent visit issues by double-checking tests, preparation requirements, scheduling conflicts, time, location, and order retrieval
• Complete and update patient registration data
• Analyze account activity and initiate resolutions
• Suggest and participate in process and quality improvements
• Monitor registration, scheduling, and insurance verification against quality standards
• Serve as a training resource for new staff and coworkers
• Perform other duties assigned by the manager

• Practice the Patients First philosophy and maintain high customer service standards
• Respond to patient questions and concerns and escalate extraordinary issues
• Maintain patient confidentiality under HIPAA regulations
• Identify and collect patient demographic information
• Schedule and direct patients through Northwestern Medicine systems
• Contact patients to schedule appointments
• Perform medical necessity checks and communicate options when appointments fail
• Inform patients about financial-account issues and provide out-of-pocket estimations
• Provide training and education as needed
• Manage schedules and complete assignments on time
• Cross-train across departments to ensure coverage
• Participate in quality assurance reviews and quality improvement activities
• Resolve service breakdowns using service recovery skills
• Communicate physician referral, insurance referral, consultation, and authorization information
• Collaborate with hospital departments, physician offices, and internal customers
• Retrieve orders and verify insurance eligibility and benefit levels using online systems and phone calls
• Complete accurate handoff instructions and Epic notes
• Run real-time eligibility checks and follow out-of-network policies
• Prevent patient-visit issues by verifying tests, preparation requirements, timing, location, orders, and duplicate records
• Complete and update patient registration data
• Monitor registration, scheduling, and insurance verification against quality standards
• Analyze account activity and initiate resolutions
• Suggest process improvements and act as a training resource for staff

• Perform patient access specialist duties
• Work remotely from the Chicago, Illinois area
• Work the day shift (1st shift)

• Practice the Patients First philosophy and deliver high standards of customer service
• Respond to patient questions and concerns and escalate extraordinary issues
• Maintain patient confidentiality under HIPAA regulations
• Identify and collect patient demographic information
• Schedule and direct patients through Northwestern Medicine systems
• Contact patients to schedule appointments
• Perform medical necessity checks and communicate options when appointments fail
• Inform patients about financial-account issues and provide out-of-pocket estimates
• Provide training and education as needed
• Manage schedules and complete assignments on time
• Cross-train across departments to ensure coverage
• Participate in quality assurance reviews of patient data
• Resolve service breakdowns using service recovery skills
• Communicate physician referral, insurance referral, and consultation information
• Collect authorization numbers and support interdepartmental communication
• Verify or print patient orders using online retrieval systems
• Verify insurance eligibility and benefits using online tools or telephone
• Complete handoff instructions and Epic notes for scheduling staff
• Run real-time eligibility checks and follow out-of-network policies
• Send accurate Epic messages and telephone encounters
• Prevent visit issues by verifying tests, preparation, timing, location, and duplicate records
• Complete and update patient registration data
• Analyze account activity and initiate resolutions
• Suggest process improvements and participate in quality improvement activities
• Monitor registration, scheduling, and insurance verification against quality standards
• Support onboarding and coworkers with process and workflow information
• Perform other duties assigned by management

• Practice the Patients First philosophy and provide exceptional customer service
• Respond to patient questions and concerns, escalating extraordinary issues to the Team Lead or Operations Coordinator
• Maintain patient confidentiality under HIPAA regulations
• Identify and collect accurate patient demographic information
• Schedule and direct patients through Northwestern Medicine systems
• Contact patients to schedule appointments
• Perform medical necessity checks and communicate options when appointments fail
• Inform patients about issues securing financial accounts
• Complete out-of-pocket cost estimates
• Provide training and education as needed
• Manage schedules and complete assignments on time
• Cross-train between departments to ensure coverage
• Participate in Quality Assurance reviews
• Resolve service breakdowns using service recovery skills
• Communicate physician referral, insurance referral, and consultation information
• Collect authorization numbers in appropriate systems
• Collaborate across units and departments and attend relevant meetings
• Use online order retrieval systems and verify or print patient orders
• Verify insurance eligibility and benefit levels using NDAS, ASF, online tools, or phone
• Document accurate handoff instructions and notes in Epic
• Run real-time eligibility checks and follow out-of-network policies
• Send accurate Epic Messages and telephone encounters
• Prevent patient-visit issues by verifying tests, preparation, schedules, locations, and duplicate records
• Complete and update patient registration data
• Analyze account activity and initiate problem resolutions
• Suggest and implement process improvements
• Monitor registration, scheduling, and insurance verification against quality standards
• Serve as a training resource for new staff and coworkers
• Perform other duties assigned by management

• Practice the Patients First philosophy and maintain high customer service standards
• Respond to patient questions and concerns, escalating extraordinary issues to the Team Lead or Operations Coordinator
• Maintain patient confidentiality under HIPAA regulations
• Provide exceptional customer service and create a positive first impression
• Identify and collect accurate patient demographic information
• Schedule and direct patients through Northwestern Medicine systems
• Contact patients to schedule appointments
• Perform medical necessity checks and communicate options when appointments fail
• Inform patients about issues securing financial accounts
• Complete out-of-pocket estimations
• Provide training and education as needed
• Manage schedules and complete tasks on time
• Cross-train between departments to ensure coverage
• Participate in quality assurance reviews of patient data
• Resolve service breakdowns using service recovery skills
• Communicate physician referral, insurance referral, and consultation information
• Collect authorization numbers in applicable systems
• Collaborate across units and departments to resolve operational issues
• Verify or print patient orders using online retrieval systems
• Verify insurance eligibility and benefits using online tools or telephone
• Document accurate handoff instructions and notes in Epic
• Run real-time eligibility checks and follow out-of-network policies
• Send descriptive and grammatically correct Epic messages and telephone encounters
• Prevent patient-visit issues by checking tests, preparation requirements, scheduling conflicts, time, location, and duplicate records
• Collect and verify the minimum registration data set
• Analyze account activity and initiate appropriate resolutions
• Suggest process improvements and participate in quality improvement activities
• Monitor registration, scheduling, and insurance verification against quality standards
• Act as a training resource for new staff and coworkers
• Perform other duties assigned by management

• Practice the Patients First philosophy and maintain high customer service standards
• Respond to patient questions and concerns; escalate extraordinary issues to Team Lead or Operations Coordinator
• Maintain patient confidentiality under HIPAA regulations
• Identify and collect accurate patient demographic information
• Schedule and direct patients through Northwestern Medicine systems
• Contact patients to schedule appointments
• Perform medical necessity checks and communicate options when appointments fail
• Inform patients about financial account issues and complete out-of-pocket estimates
• Provide training and education as needed
• Manage schedules and complete assignments on time
• Cross-train across departments to ensure coverage
• Participate in Quality Assurance reviews
• Resolve service breakdowns using service recovery skills
• Communicate physician referral, insurance referral, and consultation information
• Collect authorization numbers in applicable systems
• Verify or print patient orders using online retrieval systems
• Verify insurance eligibility and benefit levels using online tools or phone
• Complete handoff instructions and notes in Epic
• Run real-time eligibility checks and follow out-of-network policies
• Send accurate Epic messages and telephone encounters
• Prevent visit issues by checking tests, preparation, conflicts, time, location, and duplicate records
• Complete and update patient registration data
• Analyze account activity and initiate resolutions
• Suggest process improvements and participate in quality improvement activities
• Monitor registration, scheduling, and insurance verification quality standards
• Train and support new staff and coworkers
• Attend intra/interdepartmental meetings requiring walking within the NM campus
• Perform other assigned duties

• Practice the Patients First philosophy and provide high standards of customer service
• Respond to patient questions and concerns; escalate extraordinary issues to the Team Lead or Operations Coordinator
• Maintain patient confidentiality under HIPAA regulations
• Identify and collect patient demographic information
• Schedule and direct patients through Northwestern Medicine systems
• Reach out to patients to schedule appointments
• Perform medical necessity checks and communicate options when appointments fail
• Inform patients about issues securing financial accounts
• Complete out-of-pocket estimates
• Provide training and education as needed
• Manage schedules and complete tasks on time
• Cross-train across departments to ensure coverage
• Participate in Quality Assurance reviews
• Resolve service breakdowns using service recovery skills
• Communicate with patients about physician referrals, insurance referrals, and consultations
• Collect authorization numbers in applicable systems
• Collaborate across departments and support staff in direct patient-care departments
• Retrieve and verify patient orders using online systems
• Verify insurance eligibility and benefit levels using online tools or by phone
• Document accurate handoff instructions and notes in Epic
• Run real-time eligibility checks and follow out-of-network policies
• Send descriptive and grammatically correct Epic messages and telephone encounters
• Prevent visit issues by verifying tests, preparation requirements, timing, location, and order retrieval
• Ensure complete registration data, update records, and prevent duplicate patient records
• Analyze account activity, identify problems, and initiate resolutions
• Suggest and implement process improvements
• Monitor registration, scheduling, and insurance verification against quality standards
• Serve as a training resource for new staff and coworkers
• Perform other duties assigned by the manager