Participant Engagement Specialist

Job Title:Participant Engagement Specialist

Location: 932 W Washington | 5501 S Halsted | 4009 N Broadway – Chicago wide

Reports To: Iris Malave

Program/Department: Primary Care

Heartland Alliance Health’s (HAH) mission is to transform healthcare for the most vulnerable – particularly people experiencing homelessness, mental illness or addictions, or struggling with multiple chronic illnesses – improving health for all and the well-being of our community.

Join us! as The Participant Engagement Specialist who will provide advanced customer service and engagement in reception and registration to enhance the participant experience and access to health care and other services within Heartland Alliance Health. The individual in this position will handle complex support services including 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 Functions:

Duties & 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 Program Participation Form and updates participant information as assigned.
• Maintains thorough understanding of medical coverage, managed care organizations, and third party liabilities, inclusive of Medicaid and Medicare. Verifies and updates third party insurance.
• Maintains a strong familiarity with CPT codes and determines 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 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 coordination of interpretation services for participants as needed.
• Performs moderate to high volume of data entry. Assists with incoming and outgoing mail, and sorts, distributes and logs mail for participants accordingly.
• Conducts quality assurance activities to insure accuracy of program participant data and troubleshoots patient flow issues.
• Attends meetings and trainings as required.
• This position may require working at offsite locations, evening and Saturday hours.
• Other duties may be assigned.

Education and Experience:

Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Education and/or Experience: High School Diploma and three years of related experience or Associates degree and one year of related experience. Customer service experience required.
  • Prior experience in a healthcare related field or social service agency preferred.
• Certificates, Licenses, Registrations: Certificate in medical billing, medical office assistant, or a related field preferred.
• Computer Skills:Demonstrated computer proficiency, including knowledge or electronic medical record, word processing, spreadsheet and database software.
  • Ability to use computers to tabulate and analyze data and electronic technology to receive, organize, prioritize, and transmit information.
• Other Qualifications:
  • Ability to calmly and politely interact with others while addressing questions or concerns.
  • Ability to manage multiple calls and prioritize urgent participant needs per protocol. Comprehension of and appropriate use of medical terminology, new developments in the health care delivery system, application of third party payer guidelines and concepts related to quality assurance measures.
  • General knowledge of medical record keeping and accounting, medical office practices, patient relations, and medical law, ethics and federal and state health care regulations. .

Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• While performing the duties of this job, the employee is regularly required to talk and hear.
• The employee is frequently required to stand; walk; sit; use hands to finger, handle, or feel and reach with hands and arms.
• The employee is occasionally required to stoop, kneel, climb or crawl.
• Specific vision abilities required by this job include close vision and ability to adjust focus.
• The employee must occasionally lift and/or move up to 10 pounds.
• Unrestricted ability to provide physical restraint.

Work Arrangement:

Equal Opportunity Employer Statement

Heartland Alliance makes all hiring and employment decisions, and operates all programs, services, and functions without regard to race, receipt of an order of protection, creed, color, age, gender, gender identity, marital or parental status, religion, ancestry, national origin, amnesty, physical or mental disability, protected veterans status, genetic information, sexual orientation, immigrant status, political affiliation or belief, use of FMLA, VESSA, military, and family military rights, ex-offender status (depending on the offense and position to be filled), unfavorable military discharge, membership in an organization whose primary purpose is the protection of civil rights or improvement of living conditions and human relations, height, weight, or HIV infection, in accord with the organization's AIDS Policy Statement of September 1987.