Patient Access Specialist Troy Days PT

Trane Technologies•Detroit, MI

About The Position

Children’s Hospital of Michigan is an international leader in pediatric and adolescent medicine, providing surgical, imaging, emergency, critical care, rehabilitation, neonatal and perinatal services. The Patient Access Specialist serves as a system navigator and point of contact for patients and families regarding appointments and treatment authorizations. The role supports patient access operations through scheduling coordination, registration and insurance verification, authorization and referral follow-up, collection and posting of payments, document handling, and collaboration with other departments.

Requirements

High school diploma; a related associate degree is preferred.
Three or more years of prior work experience in patient access, hospital registration, health insurance, or a related area.
Course in medical terminology required.
Advanced knowledge of third-party payer requirements, reimbursements, and co-payment and deductible collections.

Nice To Haves

Associate degree in a related area.
Two or more years of prior experience in customer service or a related call center environment.

Responsibilities

Assign patient rooms, reconcile schedules, and follow up with patients to reschedule or coordinate appointments.
Obtain insurance, medical, and demographic information and verify insurance coverage and benefit levels with third-party payors.
Ensure insurance verification and authorizations are accurate and complete; work with physician offices and third-party payors to obtain referrals and authorizations for scheduled and unscheduled services, and secure inpatient visit notifications to payors.
Follow up on bill holds and resolve them in a timely manner.
Explain and secure hospital and patient legal forms, including Advance Directives, Conditions of Services, Consent for Treatment, EMTALA, and Patient Responsibility forms.
Scan protected health information and forms into the electronic medical record and/or related systems.
Notify and educate patients about financial liabilities, including co-payments, deductibles, required deposits, and payment plans; collect liabilities when applicable using proper collection techniques.
Post payments and maintain and reconcile the cash drawer.
Support departmental efficiency, including collaborating with other departments on process and operational excellence.
Participate in patient access team huddles and report on Methods, Equipment, Supplies, and Staffing (MESS).
Continue self-education regarding payer requirements and third-party regulations, with limited guidance and assistance from department management.
Maintain positive customer service and refer unresolved issues to the appropriate supervisor.