Patient Access Representative Associate

Corewell Health; Southfield (MI); On-site; USD 42,000 - 52,000; Full time

Job summary

Corewell Health Southfield Center in Michigan is hiring a full-time Patient Access Specialist to assist patients, providers, and staff with accessing services and resolving questions. This role handles inbound/outbound calls, online chat, and email while upholding established guidelines and delivering an exceptional patient experience.

You will educate members on benefits, eligibility, verification, authorization, billing, and claim status, and may assist with enrollment changes and scheduling.

Qualifications

• High school diploma or equivalent required.
• 1 year of relevant experience preferred.
• Associate’s degree is a plus.

Responsibilities

• Analyses, resolves and responds to service inquiries from members, providers, employer groups, colleagues, agents, Elite agents (customers), and others within departmental guidelines.
• Educates customers about benefits, eligibility, verification, authorization, billing, and claim status.
• Identifies and resolves or escalates customer concerns to achieve positive outcomes; may perform welcome calls to educate members on benefits.
• Adheres to procedures and guidelines in support of service promises and performance indicators; suggests process improvements.
• Assists customers with enrollment changes and relays information to other departments as needed.
• Facilitates claims resolution by following up on member calls and correspondence.
• Tracks and documents all interactions in required systems.
• Maintains productivity and adheres to work schedule; may assist with scheduling for other service lines.
• Participates in safety initiatives and related competencies as required.

Skills

Customer service

Communication

Problem solving

Education

High School Diploma or equivalent

Associate’s degree

Job description

Shift and status

Must reside in the state of Michigan

Full time, Monday through Friday. 9:00 a.m. to 5:30 p.m.

Job Summary

Assist and educate patients, providers, medical office staff, and/or Health system staff with accessing services, facilitating and resolving problems, understanding navigation questions. Consistently create an exceptional experience with each contact, via inbound and outbound calls, online chat, email, etc. Adheres to established procedure and quality guidelines in support of Patient Access Services Center performance indicators, as well as Corporate values and codes of excellence.

Essential Functions

• Analyzes, evaluates, resolves and responds to service inquires from members, providers, employer groups, colleagues, agents, Elite agents (customers), and others within departmental guidelines. Professional and pleasant interactions are ongoing expectations.
• Partnering with internal and external resources, promptly provides customers with information and education concerning benefit clarification, eligibility requirements, verification, authorization, billing and claim status.
• Promptly identifies and resolves or escalates customer concerns or complaints to achieve positive outcomes. Places outbound welcome calls to members to educate them on their benefits as needed. Assists walk-in members and agents if assigned by leadership.
• Adheres to established procedure and quality guidelines in support of Priority Health service promise, key drivers, performance indicators, as well as Corporate values and codes of excellence. Identifies potential trends or issues that impact health plan members and works with coworkers and leadership resources to suggest process improvements.
• Assists customers with administrative issues, such as submitting enrollment record changes, providing letter explaining coverage or benefits, and obtaining and relaying certain member information to other departments as needed.
• Facilitates claims resolution through follow-up on member calls and correspondence received to appropriate departments.
• Effectively tracks and/or documents all service interactions with customers within appropriate systems according to guidelines.
• Develops and maintains behaviors of productivity, availability to customers, and adherence to work schedule.
• May be trained and then assigned to perform core scheduling duties for other service lines to meet fluctuating business demands.
• Actively participates in safety initiatives and risk mitigating measures where appropriate and completes all position and unit safety related competencies and requirements on a timely basis.
• Performs other duties as assigned.

Qualifications

Required

• High School Diploma or equivalent
• 1 year of relevant experience

Preferred

• Associate’s degree

About Corewell Health

As a team member at Corewell Health, you will play an essential role in delivering personalized health care to our patients, members, and our communities. We are committed to cultivating and investing in YOU. Our top-notch teams are comprised of collaborators, leaders and innovators that continue to build on one shared mission statement - to improve health, instill humanity and inspire hope. Join a nationally recognized health system with an ambitious vision of continued advancement and excellence.

How Corewell Health cares for you

• Comprehensive benefits package to meet your financial, health, and work/life balance goals. Learn more here.
• On-demand pay program powered by Payactiv
• Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more!
• Optional identity theft protection, home and auto insurance
• Traditional and Roth retirement options with service contribution and match savings
• Eligibility for benefits is determined by employment type and status

Primary Location

SITE - Corewell Health Southfield Center - 26901 Beaumont Blvd

Department Name

Contact Center Radiology CHE - Corporate

Employment Type

Full time

Shift

Day (United States of America)

Weekly Scheduled Hours

40

Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief.

Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.

An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team.

You may request assistance in completing the application process by calling 616.486.7447.