Patient Access Rep II

Tenet Healthcare; Detroit (MI); On-site; USD 42,000 - 62,000; Full time

Benefits offered by this job

Medical, dental, vision, and life ins.

401(k) with employer match

Generous PTO

Career development and continuing ed.

Health savings accounts and flex plans

Employee Assistance program

Pet, legal, accident, and other ins.

Job summary

Tenet Healthcare's DMC Rehabilitation Institute of Michigan is seeking a Patient Access Rep II to support patient access operations and insurance verification. You will train staff, resolve complex eligibility issues, verify coverage, obtain authorizations and guide patients through billing processes to ensure accurate registrations and smooth service delivery.

The role emphasizes collaboration with Care teams and third-party payers, with focus on compliant, timely patient access and revenue

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

• Provides training and orientation on department methods, procedures and policies.
• Resolves complex eligibility or insurance verification problems with patient/family, state or government agencies, and third party payers.
• Assists Financial Counselor with financial counseling to identify and obtain payment sources.
• Verifies insurance coverage, authorizations and referrals; calculates estimated patient liability.
• Registers and schedules patients for health services and ensures necessary forms are completed correctly.

Skills

Payer knowledge

Education

High school diploma

Associate degree

Job description

Job Description - Patient Access Rep II (2606002190)

Patient Access Rep II

Description

Embark on a rewarding career with DMC Rehabilitation Institute of Michigan. If you are a compassionate healthcare professional eager to contribute to patient care, this is your opportunity where your skills make a difference every day. Join us in delivering exceptional healthcare with a personal touch.

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 participate in special projects as assigned. Communicates clinical, financial, and administrative information. Performs duties of Lead as requested. Performs other duties as assigned.

Qualifications

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

DMC Rehabilitation Institute of Michigan

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 Details

Customer Service

Primary Location

Hospital/Facility: DMC Rehabilitation Institute of Michigan

Job Type: Full-time

Shift Type: Days

Job Number: 2606002190

JOIN OUR TEAM

QUALITY CARE DELIVERED BY COMPASSIONATE PEOPLE

We know it takes a special person to work in healthcare, and we are committed to providing our people with an enriching and rewarding environment. We deliver the resources, tools and support our employees need to serve our patients and customers in the best way possible — so we can create happier, healthier communities.

COMMITTED TO DIVERSITY AND INCLUSION

At Tenet, we believe in a diverse and inclusive environment, one that is grounded in our dedication to the health and well‑being of all people. Respecting, nurturing and encouraging diversity of thought, background and experience contribute to positive work environments that result in exceptional patient care. We embrace diversity because it's our culture, and because it's the right thing to do.

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.

Upon receipt of a conditional offer of employment, applicant will be required to undergo a criminal background check.

Tenet participates in the E-Verify and Work Opportunity Tax Credit (WOTC) programs. Follow the links below for additional information.

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

WOTC: https://www.doleta.gov/business/incentives/opptax