Patient Services Representative - Part Time, Rotating days and afternoon
Saint Joseph Mercy Health System

Ann Arbor, Michigan

Posted in Medical and Nursing


Job Info


Employment Type:
Part time
Shift:
Rotating 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 Services Representative to join our Radiology Department
POSITION PURPOSE

Under limited supervision; determines need for and obtains authorization for treatment/procedures and assignment of benefits required. Provides information to patients concerning regulatory requirements. Provides estimated costs and patient responsibility, facilitating collection of co-pay, deductible and private paybalances. Responsible for the complete and accurate collection of patient demographic and financial information for the purpose of establishingthe patient and service specificrecord for claims processing and maintenance of an accurate electronic medical record. Registers and checks-in patients and determines preliminary patientand insurance liability.Performs account analysis, problem solving and resolution of patient account issues. Initiates billing and rebilling of accounts as appropriate.

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

Interviews patients and gathers information to assure accurate and timely claims submission. Interprets information collected to determine and create comprehensive visit-specific billing records.

Determines need for and obtains authorization for treatment/procedures and assignment of benefits as required.

Maintains competency by participating in on site and external training opportunities.

Utilize skills gained from training sessions to improve and enhance their work processes and customer interactions.

Provides information to patients concerning hospital policies and regulatory requirements utilizing effective interpersonal and guest-relations skills.

Provides assistance to other Health System or physician offices staff regarding registration, insurance verification and authorization requirements and processes.

Determines appropriate payment required at point of registration (deposits, co-pays, minimum charges and non-covered services.)

Collects payment at time of registration or check-out.

Based on planned services provides estimated costs and patient responsibility for both procedural and complex services.

Documents communication with patients related to estimates within the patient accounting record. Verifies procedural and diagnosis codes submitted by service departments and physicians to assure accuracy for claims submission and adjudication of reimbursement. Verifies insurance eligibility with payors. Determines benefits and ensures authorization requirement are met.

Contacts patients to discuss eligibility and benefits and requirements specific to clinical services.

Creates appropriate registration record. Communicates with patients their financial responsibility, benefit and authorization status prior to clinical services. Facilitate cash collection as appropriate prior to and at the time of service, including copays, deductibles, and private pay responsibility.

Obtains insurance authorization, patient liability acknowledgement, acknowledgement of non-covered services and advance beneficiary notices and consent forms.

Explains the purpose of these forms to patients and responds to question related to their intent. Completes as required; obtains signatures and approvals; verifies that information is complete and accurate. Is proficient at the use of automated tools and makes appropriate decisions related to the relationship of the action required and the tool used.

Our Commitment to Diversity and Inclusion

Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 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.

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



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