Rehab Reimb Asst-Family Rehab

Hurley•Flint Charter Township, MI

About The Position

The Rehab Reimbursement Assistant coordinates verification, scheduling, pre-registration, and authorization for medical services in designated outpatient rehabilitation clinics. The role collects and enters patient financial and demographic information, manages schedules to support efficient visits, communicates preparatory instructions and cost-share information, and coordinates authorization requests—particularly for government and complex managed-care patients. It handles inbound and outbound communications using telecommunications and computer information systems, while supporting patients, employees, providers, and multiple outpatient rehabilitation care areas. The role requires independent judgment, flexibility, attention to service, and participation in quality assessment and continuous quality improvement activities. Job duties are performed courteously and in accordance with Hurley Family Standards of Behavior. The position works under the direct supervision of the Rehab Office Coordinator or a departmental director, who reviews work for conformance to established policies and procedures.

Requirements

High school graduate or GED equivalent.
Knowledge of call-center operations and ability to manage high call volume while maintaining performance.
Knowledge of registration, scheduling, insurance authorization and verification, prior authorization, and referral policies and procedures for outpatient clinics and surgical settings.
Extensive knowledge of insurance plan pre-certification and referral requirements and processes.
Working knowledge of medical terminology, procedure and diagnosis coding, and billing procedures.
Proficiency with business-office information systems, including Google Suite and Microsoft Office spreadsheet and database applications.
Ability to manage multiple changing priorities effectively and in an organized manner under stressful demands while maintaining exceptional service and composure in difficult situations.
Ability to recognize high-priority situations independently, take appropriate immediate action, and make decisions in accordance with established policies and procedures.
Knowledge of hospital and/or ambulatory clinic operations.
Excellent verbal and written communication skills and a pleasant, professional phone manner.
Ability to develop effective working relationships with colleagues, physicians, providers, leaders, and others across the organization.
Genuine interest in helping patients, providers, and employees, demonstrated through polite, friendly, patient, calm, and effective communication.
Ability to work independently and make decisions in accordance with established policies and procedures.

Nice To Haves

Two years of experience working in a call center or performing scheduling, registration, billing, or front-desk responsibilities in a medical hospital, physician office, or clinic setting.

Responsibilities

Schedule, cancel, and reschedule recurring appointments and services for designated outpatient rehabilitation clinics; monitor schedules and related changes, communicate with impacted departments, and generate and distribute schedule reports.
Complete pre-registration within the designated timeframe, obtaining or verifying demographic, clinical, financial, insurance, and eligibility information and confirming or updating the primary care provider as appropriate.
Identify services requiring prior authorization or referrals and obtain authorizations and referrals for services, including requests for government and third-party payers and emergent situations.
Resubmit authorization requests or extensions for applicable plans and cases when treatment plans are extended.
Contact referring providers and track rehabilitation orders and prescriptions to ensure timely receipt, reimbursement, and continuity of care.
Provide patients with visit-specific preparatory instructions and appointment notifications, and obtain information required by third-party payors for treatment authorization requests.
Handle telephone and electronic communications with patients, families, guarantors, physicians, office staff, the medical center, and payors; respond to inquiries within 24–48 hours, address or tactfully direct complaints and problems, and escalate unresolved issues according to departmental guidelines.
Explain insurance policies and benefits to patients and refer uninsured or underinsured patients to a Financial Customer Service Specialist for assistance or governmental program screening and applications.
Maintain current guidance on services requiring pre-certification or referrals by insurance carrier, incorporating regulatory requirements and changes into daily work.
Work with the billing department to validate authorized services against procedures performed, promptly address discrepancies within payer timelines, and report procedural updates to leadership.
Triage misrouted telephone and patient portal inquiries and follow up with provider offices or payers to obtain information needed for patient visits.
Recommend policy or workflow modifications that support Hurley Medical Center values, efficiency, and data integrity.
Maintain knowledge of departmental policies, procedures, and standard work; perform effectively and accurately in a fast-paced call-center environment.
Perform other related duties, use relevant new improvements or technology, and participate in special projects as needed.