Patient Access Assistant

MyMichigan Health•Midland, MI

9h•Onsite

About The Position

The primary function of this position is to coordinate the timely completion, monitoring, and submittal of all incoming pre-authorizations for diagnostic testing procedures and surgeries. This role involves working closely with providers and patients to resolve, document, monitor, and communicate pre-authorizations. The assistant will be responsible for validating preauthorization information and completing appeals to insurance companies for denied claims related to authorization. Candidates must have a primary address located within the state of Michigan or be willing to relocate to Michigan.

Requirements

High school diploma or GED is required.
Typing skills and basic computer knowledge needed to enter patient information.
Ability to work independently, demonstrating problem-solving and organizational skills, time management skills, and initiative.
Maintains confidentiality with all patient information and data obtained.
Ability to multi-task and work under pressure of deadlines, changes in schedules, and office routines.
Ability to operate all office equipment including: computer, printer, photocopier, facsimile machine, multi-line telephone, and calculator.
Ability to work where employee may be exposed to communicable diseases.
Phone, listening, and interpersonal skills needed to communicate successfully with individuals and groups and interact with people at all levels to communicate ideas and concepts in a clear and understandable manner.
Windows PC and Internet experience is required.
Employees need to demonstrate competency in Microsoft® Windows.
Must be able to occasionally (0-33% of the workday) lift or carry 0-10 lbs.

Nice To Haves

Knowledge of medical terminology and medical office practices, policies, and procedures as normally acquired through experience working in the medical center or similar setting.
One year medical office experience in a Medical Center or similar setting.

Responsibilities

Monitors surgical/diagnostic imaging schedules to verify that pre-authorization is in place and is correct to ensure payment on high dollar accounts.
Tracks incoming pre-authorizations using the Electronic Medical Record system.
Reviews referrals within the Electronic Medical Record for accurate CPT codes.
Works directly with physician offices to ensure authorization for diagnostic testing procedures/surgeries is in place.
Provides education and training to physician offices on authorization-related issues.
Provides excellent customer service to patients via phone and in person.
Manages difficult situations that arise with the authorization process.
Coordinates investigation into denials on a weekly basis and completes retro-authorization or appeal processes.
Ensures appeals are submitted in a timely manner via mail, fax, telephone, or electronically.
Maintains positive relations with all customers, assisting with resolving questions, inquiries, and/or issues.
Leads surgery and high dollar imaging denial management for the medical center.
Effectively operates a computer using MS Office applications (Word, Excel) and vital systems for registration and insurance verification.
Delivers non-coverage paperwork or notification to patients or department leaders when required.
May work directly with the Operating Room (OR) lead scheduler or department to ensure scheduled OR/procedure time is utilized for authorized services.
May perform pre-registration responsibilities for upcoming surgeries or procedures.