Representative, Patient Access

Trinityhealth; Ann Arbor (MI); On-site; USD 42,000 - 52,000; Full time

Job summary

Trinity Health in Ann Arbor, MI is seeking a Representative (I-II) / Specialist, Patient Access to provide patient-focused registration and verification services. This role covers outpatient and inpatient registration, insurance verification, and financial interactions with patients, families, and providers.

Minimum qualifications include a high school diploma and one year of customer service experience; HFMA CRCR or NAHAM CHAA certification within a year is required.

Qualifications

• Minimum one year of customer service experience.
• HFMA CRCR or NAHAM CHAA required within one year of hire.
• Medical terminology knowledge is required.
• Insurance verification with the ability to explain benefits is preferred.

Responsibilities

• Provide patient-focused customer service and assist with outpatient and/or inpatient registration and insurance verification.
• Process payments and ensure financial requirements are met, including payer pre-certifications and referrals.
• Analyze data, create reports, and present findings to support leadership decisions.

Skills

Customer service

Medical terminology

Insurance verification

Education

High school diploma or equivalent

Job description

Employment Type

Full time

Shift

Day Shift

Job Title

Representative (I-II) / Specialist, Patient Access

EEO Code

5 Administrative support workers

Job Family

Revenue Management

Health Ministry & Department

Varies

Reports to

Supervisor, Patient Access or Manager, Patient Access

Pay grade

SO_TH_06
SO_TH_07
SO_TH_08
Varies

Purpose

Provides patient focused customer service. Performs outpatient & or inpatient registration & insurance verification functions; collects patient financial liability payments & ensures that patients meet financial requirements including Medicare medical necessity, payer pre-certifications & referrals. Provides general information to hospital users, patients, families & physician offices. Note: "patients" refers to patients, clients, residents, participants, customers, members

Essential Functions

Our Trinity Health Culture: Knows, understands, incorporates & demonstrates our Trinity Health Mission, Values, Vision, Actions & Promise in behaviors, practices & decisions. Work Focus: Researches, collects & analyzes information. Identifies opportunities, develops solutions, & leads through resolution. Collaborates on performance improvement activities as indicated by outcomes in program efficiency & patient experience. Responsible for distribution of analytical reports. Process Focus: Utilizes multiple system applications to perform analysis, create reports & develop educational materials. Incorporates basic knowledge of Trinity Health policies, practices & processes to ensure quality, confidentiality & safety are prioritized. Demonstrates knowledge of departmental processes & procedures & ability to readily acquire new knowledge. Data Management & Analysis: Research & compiles information to support ad-hoc operational projects & initiatives. Synthesizes & analyzes data & provides detailed summaries including graphical data presentations illustrating trends & recommending practical options or solutions while considering the impact on business strategy & supporting leadership decision making. Leverages program & operational data & measurements to define & demonstrate progress, ROI & impacts. Maintains a Working Knowledge of applicable federal, state & local laws / regulations, Trinity Health Integrity & Compliance Program & Code of Conduct, as well as other policies, procedures & guidelines in order to ensure adherence in a manner that reflects honest, ethical & professional behavior & safe work practices.

Functional Role

PAR I

Entry level position. Minimum one (1) year customer service experience. Patient Access experience preferred.

PAR II

Performs PAR I role & is cross trained & performs activities in Pre-Service, Emergency Department & or Bed Desk. Additional minimum qualifications: Minimum of two (2) years hospital registration or insurance verification experience upon hire. Knowledge of medical terminology, diagnostic coding & procedural coding required. Ability to explain insurance benefits.

Trinity Health Job Description

Coordinator, PA & PreService

Patient Access Account Specialist

Additional minimum qualification of two plus (2+) years hospital registration or insurance verification experience. Uses specialized knowledge to support key areas of the organization related to an area of expertise. Uses data, research analysis, critical thinking & problem-solving skills to support colleagues & leadership in achieving organization's strategic objectives. Serves as a peer influencer & may direct a project or project team by applying industry experience & specialized knowledge. Responsible for analyzing, processing & editing for correctness based on payer guidelines. Resolves items & ensures claims are billed accurately. Processes payments timely.

Minimum Qualifications

High school diploma or equivalent.

HFMA CRCR or NAHAM CHAA required within one (1) year of hire.

Additional Qualifications (nice to have)

Medical terminology required & knowledge of diagnostic & procedural coding.

Insurance verification with the ability to explain benefits, secure necessary authorizations.

Physical & Mental Requirements & Working Conditions

Direct Healthcare Services / Indirect Healthcare / Support Services: Exposure to conditions which may be considered unpleasant to sight, touch, sound & or smell. Occasional Exposure to fumes, odors, dusts, mists & gases, biohazards / hazards (mechanical, electrical, burns, chemicals, radiation, sharp objects, etc.). Occasional Exposure to or subject to noise, infectious waste, diseases & conditions. Occasional Exposure to interruptions, shifting priorities & stressful situations. Frequent Ability to follow tasks through to completion, understand & relate to complex ideas / concepts, remember multiple tasks & regimens over long periods of time & work on concurrent tasks / projects. Continuous Ability to read small print, hear sounds & voice / speech patterns