Be the system navigator and point of contact for patients and families regarding their appointments and authorizations for treatment. Assigns patient rooms, reconcile schedules, follow-up with patients to reschedule or coordinate appointments. Obtains insurance, medical, and demographic data and verifies insurance coverage and benefit levels with third-party payors. Ensure accurate and correct insurance verification and authorizations have been obtained and work with physician offices and third party payors to obtain referrals/authorizations for scheduled & unscheduled services as needed and secure inpatient visit notification to payors. Follow-up on bill holds to resolve in a timely manner. Thoroughly explains and secures Hospital and patient legal forms (i.e. Advance Directives, Conditions of Services, Consent for Treatment, EMTALA, Patient Responsibility, etc). Scan protected health information and forms into EMR and/or related systems. Notifies and educates patients about financial liabilities (co-payments, deductibles or required deposits and payment plans) and collects the liability when applicable while employing proper patient liability collection techniques. Post payments and maintain/reconcile cash drawer. Responsible for duties in support of departmental efficiencies including but not limited to collaborating with various departments in process and operational excellence. Participates in patient access team in department huddles and report out on Methods, Equipment, Supplies, and Staffing (MESS). Responsible for continuing self-education regarding payer requirements and third party regulations under limited guidance and assistance of department management. Maintains positive customer service at all times, refine and clarify referring unresolved issues to appropriate supervisor. [BRASSRING IMPORT 8/25/16]
1. High school diploma, associate degree in related area preferred. 2.Three or more years prior work experience in patient access, hospital registration, health insurance or related area. 3.Two or more years prior experience in Customer Service or related call center environment preferred. 4.Advanced knowledge of third party payers requirements, reimbursements and copayments/deductible collections etc.5. Course in medical terminology required. [BRASSRING IMPORT 8/25/16]
Primary Location: Troy, Michigan
Facility: DMC Children's Hospital of Michigan
Job Type: Full-time
Shift Type: Days
Employment practices will not be influenced or affected by an applicantâ��s or employeeâ��s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.
Internal Number: 1905023124
About DMC Children's Hospital of Michigan
“Tenet Healthcare Corporation is a diversified healthcare services company with 115,000 employees united around a common mission: to help people live happier, healthier lives. Through its subsidiaries, partnerships and joint ventures, including United Surgical Partners International, the Company operates general acute care and specialty hospitals, ambulatory surgery centers, urgent care centers and other outpatient facilities. Tenet's Conifer Health Solutions subsidiary provides technology-enabled performance improvement and health management solutions to hospitals, health systems, integrated delivery networks, physician groups, self-insured organizations and health plans.