REMOTE Scheduling Specialist I

Trinity Health•Livonia, MI

2d•$17 - $26•Remote

About The Position

POSITION PURPOSE Responsible for scheduling, pre-registering patients for outpatient radiology exams. Electronically verifying insurance eligibility & accurately identifying & collecting patient financial responsibility. This is a key position that begins the overall patient experience and initiates the billing process for any services provided by the hospital. As a mission-driven innovative health organization, we will become the national leader in improving the health of our communities and each person we serve. By demonstrating reverence, commitment to those who are poor, justice, stewardship, and integrity, our organization will continue to provide better health, better care, at lower costs. ESSENTIAL FUNCTIONS Responsible for pre-registration, scheduling, electronically verifying insurance eligibility & accurately identifying & collecting patient financial responsibility. Handles complex scheduled events, including high dollar testing, associated studies & those with study specific instructions & communicates effectively to service delivery areas to maximize patient flow & customer service. Begins the overall patient experience & initiate the billing process for any services provided by the hospital. Analyzes patient insurance(s), identifies the correct insurance plan, selects appropriately from HIS insurance and plan selections and documents correct insurance order. Applies recurring visit processing according to protocol. Verifies patient information with third party payers. Collects insurance referrals and documents within HIS. Communicates with patients and physician/offices regarding authorization/referral requirements. Identifies potential need for financial responsibility forms or completed electronic forms with patients as necessary. Escalates accounts appropriately in accordance with department Defer/Delay policy to manager. Screens outpatient visits for medical necessity and issues Advanced Beneficiary Notice as appropriate for Medicare primary outpatients. Provides cost estimates. Collects and documents Medicare Secondary Payer Questionnaire (MSPQ) and obtains information from the patient if third party payers need to be billed (i.e., worker's compensation, motor vehicle accidents and any other applicable payer). Maintains operational knowledge of regulatory requirements and guidelines as outlined in the hospital and department Compliance Plans. Ensures Meaningful Use requirements are met as appropriate. Screens all patients self-pay & out of network patients using approved technology. Provides information for follow up and referral to the RHM Medicaid Vendor and/or Financial Counselor as appropriate. Initiates payment plans and obtains payment. Informs and explains all applicable government and private funding programs and other cash payment plans or discounts to the patient and/or family. Incorporates point of service (POS) collection processes into daily functions. Must possess the ability to comply with Trinity Health policies and procedures. Must be comfortable operating in a collaborative, shared leadership environment. Must possess a personal presence that is characterized by a sense of honesty, integrity, and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals, and values of Trinity Health. Other duties as assigned by manager.

Requirements

High School Diploma or equivalent.
Two (2) to Five (5) years experience in area of expertise such as scheduling, financial clearance, or patient access.
National certification in HFMA CRCR or NAHAM CHAA required within one (1) year of hire.
Must be proficient in the use of Patient Registration/Patient Accounting systems & related software systems.

Nice To Haves

Associates Degree, preferred.
Comprehensive knowledge of scheduling with mastery in at least three (3) or more modalities & insurance verification processes with three (3) years scheduling experience in an acute care setting
Experience in complex facility based ancillary testing across multiple facilities/states
Strong knowledge of third-party & government payer billing & reimbursement guidelines as well as department performance standards & policies & procedures

Responsibilities

Responsible for pre-registration, scheduling, electronically verifying insurance eligibility & accurately identifying & collecting patient financial responsibility.
Handles complex scheduled events, including high dollar testing, associated studies & those with study specific instructions & communicates effectively to service delivery areas to maximize patient flow & customer service.
Begins the overall patient experience & initiate the billing process for any services provided by the hospital.
Analyzes patient insurance(s), identifies the correct insurance plan, selects appropriately from HIS insurance and plan selections and documents correct insurance order.
Applies recurring visit processing according to protocol.
Verifies patient information with third party payers.
Collects insurance referrals and documents within HIS.
Communicates with patients and physician/offices regarding authorization/referral requirements.
Identifies potential need for financial responsibility forms or completed electronic forms with patients as necessary.
Escalates accounts appropriately in accordance with department Defer/Delay policy to manager.
Screens outpatient visits for medical necessity and issues Advanced Beneficiary Notice as appropriate for Medicare primary outpatients.
Provides cost estimates.
Collects and documents Medicare Secondary Payer Questionnaire (MSPQ) and obtains information from the patient if third party payers need to be billed (i.e., worker's compensation, motor vehicle accidents and any other applicable payer).
Maintains operational knowledge of regulatory requirements and guidelines as outlined in the hospital and department Compliance Plans.
Ensures Meaningful Use requirements are met as appropriate.
Screens all patients self-pay & out of network patients using approved technology.
Provides information for follow up and referral to the RHM Medicaid Vendor and/or Financial Counselor as appropriate.
Initiates payment plans and obtains payment.
Informs and explains all applicable government and private funding programs and other cash payment plans or discounts to the patient and/or family.
Incorporates point of service (POS) collection processes into daily functions.
Must possess the ability to comply with Trinity Health policies and procedures.
Must be comfortable operating in a collaborative, shared leadership environment.
Must possess a personal presence that is characterized by a sense of honesty, integrity, and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals, and values of Trinity Health.
Other duties as assigned by manager.