Patient Service Rep - SJMHS Chelsea
About The Position
Provides patient focused customer service. Performs outpatient & / or inpatient registration & insurance verification functions; collects patient financial liability payments & ensures that patients meet financial requirements including Medicare medical necessity, payer pre-certifications & referrals. Provides general information to hospital users, patients, families & physician offices. Note: “patients” refers to patients, clients, residents, participants, customers, members. Our Trinity Health Culture: Knows, understands, incorporates & demonstrates our Trinity Health Mission, Values, Vision, Actions & Promise in behaviors, practices & decisions. Work Focus: Researches, collects & analyzes information. Identifies opportunities, develops solutions, & leads through resolution. Collaborates on performance improvement activities as indicated by outcomes in program efficiency & patient experience. Responsible for distribution of analytical reports. Process Focus: Utilizes multiple system applications to perform analysis, create reports & develop educational materials. Incorporates basic knowledge of Trinity Health policies, practices & processes to ensure quality, confidentiality & safety are prioritized. Demonstrates knowledge of departmental processes & procedures & ability to readily acquire new knowledge. Data Management & Analysis: Research & compiles information to support ad-hoc operational projects & initiatives. Synthesizes & analyzes data & provides detailed summaries including graphical data presentations illustrating trends & recommending practical options or solutions while considering the impact on business strategy & supporting leadership decision making. Leverages program & operational data & measurements to define & demonstrate progress, ROI & impacts. Maintains a Working Knowledge of applicable federal, state & local laws / regulations, Trinity Health Integrity & Compliance Program & Code of Conduct, as well as other policies, procedures & guidelines in order to ensure adherence in a manner that reflects honest, ethical & professional behavior & safe work practices. Functional Role (not inclusive of titles or advancement career progression) PAR I Entry level position. Minimum one (1) year customer service experience. Patient Access experience preferred. PAR II Performs PAR I role & is cross trained & performs activities in Pre-Service, Emergency Department & / or Bed Desk. Additional minimum qualifications: Minimum of two (2) years hospital registration or insurance verification experience upon hire. Knowledge of medical terminology, diagnostic coding & procedural coding required. Ability to explain insurance benefits. Trinity Health Job Description Coordinator, PA & PreService Patient Access Account Specialist Additional minimum qualification of two plus (2+) years hospital registration or insurance verification experience. Uses specialized knowledge to support key areas of the organization related to an area of expertise. Uses data, research analysis, critical thinking & problem-solving skills to support colleagues & leadership in achieving organization’s strategic objectives. Serves as a peer influencer & may direct a project or project team by applying industry experience & specialized knowledge. Responsible for analyzing, processing & editing for correctness based on payer guidelines. Resolves items & ensures claims are billed accurately. Processes payments timely.
Requirements
- Minimum one (1) year customer service experience
- High school diploma or equivalent
- HFMA CRCR or NAHAM CHAA required within one (1) year of hire
- Medical terminology required
- Knowledge of diagnostic & procedural coding
- Insurance verification with the ability to explain benefits, secure necessary authorizations
- Ability to follow tasks through to completion, understand & relate to complex ideas / concepts, remember multiple tasks & regimens over long periods of time & work on concurrent tasks / projects
- Ability to read small print, hear sounds & voice / speech patterns, give / receive instructions & other verbal communications (in-person & / or over the phone / computer / device / equipment assigned) with some background noise
- Perform manual dexterity activities & / or grasping / handling
- Use a computer / other technology
- Sit with the ability to vary / adjust physical position or activity
- Maintain a safe working environment & use available personal protective equipment (PPE)
- Comply with Trinity Health’s Code of Conduct, policies, procedures & guidelines
- Perform activities that require standing / walking with the ability to vary / adjust physical position or activity
- Lift a maximum of 30 pounds unassisted
- Use upper & lower extremities, engage in bending / stooping / reaching & pushing / pulling
- Work indoors (subject to travel requirements) under temperature-controlled & well-lit conditions
- Perform activities that require standing / walking with the ability to vary / adjust physical position or activity
- Lift a maximum of 30 pounds unassisted
- Experience of long periods of walking / standing / stooping / bending / pulling & / or pushing
- Encounter a clinical / patient facing / hands on interactive work environment
Nice To Haves
- Patient Access experience preferred
- Minimum of two (2) years hospital registration or insurance verification experience upon hire
- Knowledge of medical terminology, diagnostic coding & procedural coding required
- Ability to explain insurance benefits
- Additional minimum qualification of two plus (2+) years hospital registration or insurance verification experience
- Ability to climb, kneel, crouch & / or operate foot controls
- Ability to provide assistance in the event of an emergency
- Encounter worksites (e.g., patient homes) or travel to worksites that may have variable internal & external environmental conditions
- Perform work that involves physical efforts (e.g., transporting, moving, positioning & / or ambulating patients)
Responsibilities
- Performs outpatient & / or inpatient registration & insurance verification functions
- Collects patient financial liability payments & ensures that patients meet financial requirements including Medicare medical necessity, payer pre-certifications & referrals
- Provides general information to hospital users, patients, families & physician offices
- Researches, collects & analyzes information
- Identifies opportunities, develops solutions, & leads through resolution
- Collaborates on performance improvement activities as indicated by outcomes in program efficiency & patient experience
- Responsible for distribution of analytical reports
- Utilizes multiple system applications to perform analysis, create reports & develop educational materials
- Incorporates basic knowledge of Trinity Health policies, practices & processes to ensure quality, confidentiality & safety are prioritized
- Demonstrates knowledge of departmental processes & procedures & ability to readily acquire new knowledge
- Research & compiles information to support ad-hoc operational projects & initiatives
- Synthesizes & analyzes data & provides detailed summaries including graphical data presentations illustrating trends & recommending practical options or solutions while considering the impact on business strategy & supporting leadership decision making
- Leverages program & operational data & measurements to define & demonstrate progress, ROI & impacts
- Maintains a Working Knowledge of applicable federal, state & local laws / regulations, Trinity Health Integrity & Compliance Program & Code of Conduct, as well as other policies, procedures & guidelines in order to ensure adherence in a manner that reflects honest, ethical & professional behavior & safe work practices
- Performs PAR I role & is cross trained & performs activities in Pre-Service, Emergency Department & / or Bed Desk
- Uses specialized knowledge to support key areas of the organization related to an area of expertise
- Uses data, research analysis, critical thinking & problem-solving skills to support colleagues & leadership in achieving organization’s strategic objectives
- Serves as a peer influencer & may direct a project or project team by applying industry experience & specialized knowledge
- Responsible for analyzing, processing & editing for correctness based on payer guidelines
- Resolves items & ensures claims are billed accurately
- Processes payments timely
Benefits
- Equal Opportunity Employer
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
