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Mercy Medical Center Clinton Patient Access Rep I Full Time in Saint Joseph Mercy Health System Hospital Campus - Ann Arbor, Michigan

Employment Type:

Full time

Shift:

Description:

Saint Joseph Mercy Health System, one of the nation's top health care services providers, spanning five counties in Southeastern Michigan. SJMHS represents more than 2,700 physicians and 14,000 nurses and staff, and includes 6 Hospitals, 5 Outpatient Health Centers, 8 Urgent Care Facilities and over 25 Specialty Centers.

An opportunity exists for a Patient Access Representative to join our Central Scheduling Department.

POSITION PURPOSE

  • Interviews patients and physician office staff to obtain information and appropriately

  • schedule patients for future and same day basic radiology services using Cerner Enterprise Scheduling applications. Interviews patients and gathers information to assure accurate and timely scheduling, registration, insurance verification and claims submission.

  • Interprets information collected to determine and create comprehensive patient and visit specific medical and billing records.

  • Determines need for authorization for treatment/procedures and coordination of benefits as required.

  • Utilizes multiple system applications simultaneously to complete the scheduling, order management, pre-registration and insurance verification processes including but not limited to Cerner Scheduling, EPIC Patient Management and Patient Accounting, Powerchart, Freedom Imaging, Pathways Compliance Advisor, Emdeon Real Time Eligibility, Excel (was/is lists – order translation documents), Avaya CMS.

  • Provides information to patients concerning hospital policies and regulatory requirements utilizing exceptional interpersonal skills.

  • Obtains dates of previous services to determine eligibility for future services using Powerchart.

  • Uses prior study physician recommendations from Powerchart to determine appropriate next test to schedule.

  • Translates clinical information on physician orders to clinical order terminology to appropriately schedule patients for future services.

  • Responsible for scheduling STAT appointments, block appointments and obtaining department approvals for complex procedures.

  • Processes internet requests for scheduling services. Ensures appropriate communication to patient requesting services.

  • Indexes incoming radiology physician orders using fax queue application (Freedom Imaging).

  • Provides assistance to other Health System or physician offices staff regarding registration information and procedures.

  • Determines appropriate payment required at point of registration (deposits and minimum charges for non-covered services).

  • Using EPIC, pre-registers patients prior to clinical services. (Refer to job description for Patient Service Representative.)

  • Verifies insurance coverage using Real Time Eligibility for selected services to facilitate cash collection.

  • Performs medical necessity screening for applicable services for Medicare patients.

  • Follow-up with patients and ordering physicians appropriately to communicate responsibility related to services found to be not medically necessary.

  • Responds to problems and questions from Medical Records, Clinical Departments or PFS Teams.

  • Reviews, analyzes and corrects report entries to ensure accurate scheduling and registration, and makes sure insurance and billing requirements are met prior to services being rendered.

  • Demonstrates understanding of prevailing regulatory and 3rd party requirements (MSP, authorizations, PCA, consent forms, ABN, etc.). Assists patients or physician office staff by referring them to the appropriate sources of information.

  • Identifies opportunities to improve the quality of scheduling, registration and/or verification processes.

  • Responds to patient questions concerning their scheduled services, registration, insurance eligibility and payment requirements as related to services they are scheduled to have.

  • Demonstrates accountability to follow-up with patients concerning requests for information of action regarding their appointment and/or account.

  • Knows where to obtain information to assist PFS team members, patients, and internal or external customers.

  • Demonstrates team-player abilities and seamless service to patients.

  • Maintains good rapport and cooperative relationships.

  • Approaches conflict in a constructive manner.

  • Helps to identify problems, offer solutions, and participate in their resolution.

  • Maintains the confidentiality of information acquired pertaining to patient, physicians, employees, and visitors to St. Joseph Mercy Hospital.

  • Discusses patient and hospital information only among appropriate personnel in appropriately private places. Behaves in accordance with the Mission, Vision, and Values of Saint Joseph Mercy Health System.

  • Assumes responsibility for performance of job duties in the safest possible manner, to assure personal safety and that of coworkers, and to report all preventable hazards and unsafe practices immediately to management.

REQUIRED EDUCATION, EXPERIENCE AND LICENSURE

Education:

Requires high school diploma or equivalent. 1-2 years post high school education and/or training or the equivalent.

Preferred Experience:

One or two years related experience.

Preferred Certification:

Certified Healthcare Access Associate (CHAA through NAHAM)

REQUIRED SKILLS AND ABILITIES

  • Demonstrated computerized system application experience.

  • Critical thinking and problem solving skills.

  • Analytical ability to effectively and efficiently resolve registration, scheduling and insurance issues.

  • Demonstrated knowledge of the Revenue Cycle processes, components and terminology.

  • Exceptional interpersonal communication skills to effectively communicate with patients, team members, clinical colleagues, medical staff, external agencies and contacts.

  • Exceptional customer services skills and positive personality attributes.

  • Patience in dealing with ordinary, arduous or emotional patients.

  • Use of telephones and call center technology.

  • Ability to type at 35-40 WPM.

WORKING CONDITIONS

  • Call Center office environment.

REPORTING RELATIONSHIPS

  • Supervision provided by PFS Manager.

Employees of St. Joseph Mercy Health System enjoy…

  • Competitive compensation

  • Full benefits package including Medical, Dental, Vision, PTO, Life Insurance and Disability

  • Retirement savings plan with employer contribution

  • Opportunity for growth and advancement throughout SJMHS and Trinity Health

Visit www.stjoeshealth.org/careers to learn more about the benefits, culture and career development opportunities available to you at Saint Joseph Mercy Health System

Trinity Health's Commitment to Diversity and Inclusion

Trinity Health employs about 133,000 colleagues at dozens of hospitals and hundreds of health centers in 22 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.

Trinity Health's dedication to diversity includes a unified workforce (through training and education, recruitment, retention and development), commitment and accountability, communication, community partnerships, and supplier diversity.

Trinity Health is one of the largest multi-institutional Catholic health care delivery systems in the nation, serving diverse communities that include more than 30 million people across 22 states. Trinity Health includes 94 hospitals, as well as 109 continuing care locations that include PACE programs, senior living facilities, and home care and hospice services. Its continuing care programs provide nearly 2.5 million visits annually.

Based in Livonia, Mich., and with annual operating revenues of $17.6 billion and assets of $24.7 billion, the organization returns $1.1 billion to its communities annually in the form of charity care and other community benefit programs. Trinity Health employs about 133,000 colleagues, including 7,800 employed physicians and clinicians.

Committed to those who are poor and underserved in its communities, Trinity Health is known for its focus on the country's aging population. As a single, unified ministry, the organization is the innovator of Senior Emergency Departments, the largest not-for-profit provider of home health care services — ranked by number of visits — in the nation, as well as the nation’s leading provider of PACE (Program of All Inclusive Care for the Elderly) based on the number of available programs. For more information, visit www.trinity-health.org at http://www.trinity-health.org/ . You can also follow @TrinityHealthMI on Twitter.

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