Call Center Representative - Michigan Heart

Trinity Health • Ypsilanti, MI

394d

About The Position

The Call Center Representative at Trinity Health Michigan is responsible for managing the Patient Access Process, which includes scheduling, registration, and insurance verification for cardiology services. This role requires effective communication with patients and physician office staff to ensure accurate scheduling and coordination of services, while also handling insurance and financial responsibilities. The representative will work under general supervision during business hours, focusing on providing exceptional service and support to patients and healthcare providers.

Requirements

• Requires high school diploma or equivalent.
• 1-2 years post high school education and/or training or the equivalent.
• 1 to 2 years of related experience.

Responsibilities

• Interviews patients and physician office staff to obtain information and appropriately schedule patients for future and same day basic cardiology services.
• 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.
• 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.
• Uses prior study physician recommendations 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.
• Verifies insurance coverage using Real Time Eligibility for selected services to facilitate cash collection.
• Performs medical necessity screening for applicable services for Medicare patients.
• 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.

What This Job Offers

• Job Type: Full-time
• Industry: Hospitals
• Education Level: High school or GED
• Number of Employees: 1,001-5,000 employees