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.
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 payer's requirements, reimbursements and copayments/deductible collections etc.
5. Course in medical terminology required.
Primary Location: Troy, Michigan
Facility: DMC Children's Hospital of Michigan
Job Type: PT1
Shift Type: Rotate
If Other Shift, Specify: Rotate from Days/Afternoon
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: 2105009340
About DMC Children's Hospital of Michigan
Tenet Healthcare Corporation (NYSE: THC) is a diversified healthcare services company headquartered in Dallas with 112,000 employees. Through an expansive care network that includes United Surgical Partners International, we operate 65 hospitals and approximately 510 other healthcare facilities, including surgical hospitals, ambulatory surgery centers, urgent care and imaging centers and other care sites and clinics. We also operate Conifer Health Solutions, which provides revenue cycle management and value-based care services to hospitals, health systems, physician practices, employers and other clients. Across the Tenet enterprise, we are united by our mission to deliver quality, compassionate care in the communities we serve.