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Mercy Medical Center Clinton Patient Access Concierge in United States

Employment Type:

Full time

Shift:

Description:

Patient Access Concierge I

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.

POSITION PURPOSE

Greets patients and family members, obtains, and verifies demographic, clinical, financial, and insurance information during the (pre)-registration process, accepts point of service payments or provides guidance for payment options, and clears the patient for service delivery.

Core responsibilities include:

Verifies patient identification, demographic information, and insurance coverage. Accepts point of service payments. Enters patient information accurately into appropriate hospital information system(s). Refers patients with questions regarding financial liability to appropriate resource(s). Accepts medical authorization or referral forms, if appropriate. Processes key documents to facilitate obtaining insurance information. Provides payment estimates for out of pocket costs. Educates patients/families on the use of registration kiosks or online systems. Identifies routine issues and escalates to Lead Patient Access Concierge.

ESSENTIAL FUNCTIONS

Knows, understands, incorporates, and demonstrates the Trinity Health Mission, Core Values, and Vision in behaviors, practices, policies and decisions.

Maintains compliance with HIPAA and other regulatory requirements throughout all activities. Protects the safety of patient information by verifying patient identity to preserve the integrity of the patient record and ensures all records are complete, accurate, and unique to one patient.

Performs pre-registration, insurance verification and financial clearance activities in a variety of settings and for multiple patient types. Communicates frequently with patients/family members/guarantors, and physicians or their office staff in the deployment of key activities. Interviews patients to collect data, initiates electronic medical records, validates and enters data related to procedures, tests and diagnoses. Determines need for appropriate service authorizations (pre-certifications, third-party authorizations, referrals) and contacts physicians and Case Management/Utilization Review personnel, as needed. Obtains and verifies the accuracy and completeness of physician orders for tests and procedures, which includes name, date of birth, diagnosis, procedure, date, and physician signature to minimize risk to hospital reimbursement. Accurately uses the patient search feature to find the correct patient information and disseminates data to clinical systems for patient care. Identifies required forms or templates based on the types of services patients will receive.

Performs insurance eligibility/benefit verification, utilizing EDI transactions and payer web access, and calls payers directly. Documents information within the patient accounting system through insurance eligibility/benefit verification. Refers accounts identified as self-pay to benefit advocacy resources. Conducts data search of manuals, physician systems, previous accounts or payment source history, when appropriate.

Provides financial information and patient payment options. Informs patient/guarantor of liabilities and collects appropriate patient liabilities, including co-payments, co-insurances, deductibles, deposits and outstanding balances at the point of pre-registration or point of service. Documents payments/actions in the patient accounting system and provides the patient with a patient estimate of out of pocket costs and a payment receipt in the collection of funds. Acquires necessary documents including patient identification, insurance cards, consent for treatment, assignment of benefits, release of information, waivers, ABNs, advance directives, etc. Identifies need for patient/guarantor signature based on patient encounter/visit. Scans appropriate documents.

Provides information and assistance to patients, family members and visitors in a courteous, professional, and empathetic manner; ensuring timely, efficient customer service in a fast paced, high energy environment. Communicates with various ancillary departments to ensure smooth patient flow and high data integrity.

Cross trains in various functions to assist in the timely delivery of department services. Performs routine duties relating to patient placement, reservation duties, which includes responsibility for bed assignments, transfers, and providing functional guidance as necessary.

Performs scheduling of patients using HIS or scheduling software as necessary.

Interprets data, draws conclusions, and reviews findings with Lead Patient Access Concierge for further review.

Takes initiative to continuously learn all aspects of Patient Access Concierge Role to support progressive responsibility.

Other duties as needed and assigned by the manager.

Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Trinity Health’s Organizational Integrity Program, Standards of Conduct, as well as other policies and procedures to ensure adherence in a manner that reflects honest, ethical, and professional behavior.

PERFORMANCE METRICS

Trinity Health's Commitment to Diversity and Inclusion

Trinity Health employs about 133,000 colleagues at dozens of hospitals and hundreds of health centers in 22 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.

Trinity Health's dedication to diversity includes a unified workforce (through training and education, recruitment, retention and development), commitment and accountability, communication, community partnerships, and supplier diversity.

Trinity Health is one of the largest multi-institutional Catholic health care delivery systems in the nation, serving diverse communities that include more than 30 million people across 22 states. Trinity Health includes 94 hospitals, as well as 109 continuing care locations that include PACE programs, senior living facilities, and home care and hospice services. Its continuing care programs provide nearly 2.5 million visits annually.

Based in Livonia, Mich., and with annual operating revenues of $17.6 billion and assets of $24.7 billion, the organization returns $1.1 billion to its communities annually in the form of charity care and other community benefit programs. Trinity Health employs about 133,000 colleagues, including 7,800 employed physicians and clinicians.

Committed to those who are poor and underserved in its communities, Trinity Health is known for its focus on the country's aging population. As a single, unified ministry, the organization is the innovator of Senior Emergency Departments, the largest not-for-profit provider of home health care services — ranked by number of visits — in the nation, as well as the nation’s leading provider of PACE (Program of All Inclusive Care for the Elderly) based on the number of available programs. For more information, visit www.trinity-health.org . You can also follow @TrinityHealthMI on Twitter.

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