Patient Access Rep II

Detroit Medical Center; Detroit (MI); On-site; USD 38,000 - 48,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

Life insurance

401(k) with match

Paid time off

Career development

HSA/FSA

Employee assistance program

Employee discounts

Pet insurance

Job summary

DMC Rehabilitation Institute of Michigan in Detroit is seeking a Patient Access/Admitting professional. Under limited supervision you will verify insurance, determine eligibility, register patients, and schedule services, ensuring accurate data collection and compliant billing processes.

You will train staff, assist financial counselors, and collaborate with third-party payers to resolve complex cases, while contributing to bed management and timely billing.

Qualifications

• High school diploma, associate degree in related area desired.
• Two to three years of progressively more responsible experience in patient access, hospital registration or related area.
• Advanced knowledge of third party payers requirements, reimbursements and copayments/deductible collections etc.

Responsibilities

• Provide training and orientation on department methods, procedures and policies.
• Resolve complex eligibility or insurance verification problems with patient or patient family, state or government agencies, other hospital departments and third party payers.
• Assist Financial Counselor with financial counseling services to help patients in identifying and obtaining payment sources.
• Verifies insurance coverage and benefits, obtains and analyzes necessary authorizations and referrals, and calculates estimated patient liability.
• Registers and schedules patients for health services ensuring appropriateness of setting for services provided.
• Obtains accurate insurance, medical and demographic data to admit or pre-admit patients to the health facility.
• Determines patient co-pay/deductibles and collects payment as outlined in hospital policies.
• Completes telephone registrations as appropriate.
• Assists patients in completing necessary forms and obtains patient signature as needed.
• Completes special projects as assigned.

Education

High school diploma, associate degree in related area desired

Job description

Benefits Statement

• Medical, dental, vision, and life insurance
• 401(k) retirement savings plan with employer match
• Generous paid time off (PTO)
• Career development and continuing education opportunities
• Health savings accounts, healthcare & dependent flexible spending accounts
• Employee Assistance program, Employee discount program
• Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, auto & home insurance

Note: Eligibility for benefits may vary by location and is determined by employment status

Job Summary / Responsibilities

Under limited supervision functions as a resource to Patient Access Representative I. Provides training and orientation on department methods, procedures and policies. Provides input for establishing departmental policies and procedures. In conjunction with Lead, resolves complex eligibility or insurance verification problems through contacts with patient or patient family, state or government agencies, other hospital departments and third party payers.

Assists Financial Counselor with financial counseling services to help patients in identifying and obtaining payment sources. Resolves complex and/or sensitive issues and recommends appropriate actions. Participates in bed management as defined in operating unit policies and procedures. Verifies insurance coverage and benefits, obtains and analyzes necessary authorizations and referrals, and calculates estimated patient liability. Reviews, monitors, and reconciles patient accounts to ensure accurate bill production.

Ensures compliance with third party payer requirements. Registers and schedules patients for health services ensuring appropriateness of setting for services provided Explains appropriate forms to patient and family and ensures that necessary consent, regulatory forms, and MSP questionnaire (if applicable) are completed correctly and that patient signatures are obtained. Obtains accurate insurance, medical and demographic data to admit or pre-admit patients to the health facility. Verifies insurance coverage and benefit levels with various third party payers and analyzes authorization and referrals, calculates estimated patient liability.

Determines patient co-pay/deductibles and collects payment as outlined in hospital policies. Assists patients without medical insurance coverage in completing medical assistance applications and/or making payment arrangement and cash collections. Coordinates scheduling of all tests and/or services utilizing current clinical guidelines.

Develops liaison relationship between patient and health facility by answering patients questions regarding health facility policies and billing procedures and by obtaining necessary information to efficiently register and accurately bill for services rendered. Assists patients in completing necessary forms and obtains patient signature as needed. Collects referrals and authorizations; attempts to secure telephone referral if necessary.

Completes telephone registrations as appropriate. Resolves bill holds in a timely manner to ensure completion within 5-day bill hold reconciles and corrects any rejected transactions on user specific Transmission, Control and Errors (TCE) reports. Assist and participates in special projects as assigned. Communicates clinical, financial, and administrative information. Performs duties of Lead as requested. Performs other duties as assigned.

Qualifications

• High school diploma, associate degree in related area desired.
• Two to three years of progressively more responsible experience in patient access, hospital registration or related area.
• Advanced knowledge of third party payers requirements, reimbursements and copayments/deductible collections etc.

Qualifications - External

DMC Rehabilitation Institute of Michigan is one of the nation’s largest hospitals specializing in rehabilitation medicine and research. RIM is known for its clinical expertise in spinal cord injury, brain injury, stroke, amputee, orthopedics and catastrophic injury care. The Institute houses the Center for Spinal Cord Injury Recovery and the Southeast Michigan Traumatic Brain Injury System (SEMTBIS), one of only 16 federally designated model systems of care for brain injury care and research. RIM also operates 31 outpatient sites throughout southeast Michigan specializing in sports medicine and orthopedics.

EEO Statement

Employment practices will not be influenced or affected by an applicant’s or employee’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.

Tenet participates in the E-Verify program. Follow the link below for additional information.

E-Verify: http://www.uscis.gov/e-verify

The employment practices of Tenet Healthcare and its companies comply with all applicable laws and regulations

Job: Patient Access/Admitting

Primary Location: Detroit, Michigan

Facility: DMC Rehabilitation Institute of Michigan

Job Type: Full Time

Shift Type: Day

The employment practices will not be influenced or affected by an applicant’s or employee’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.

Tenet participates in the E-Verify program. Follow the link below for additional information.

E-Verify: http://www.uscis.gov/e-verify

The employment practices of Tenet Healthcare and its companies comply with all applicable laws and regulations.

2606002190

Employment practices will not be influenced or affected by an applicant’s or employee’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.