Job Description

Employment Type:

Full time

Shift:

Day Shift

Description:

Job Title: Representative (I-II) / Specialist, Patient Access

EEO Code:

5 Administrative support workers

Job Family: Revenue Management

Health Ministry & Department:

Varies

Reports to:

Supervisor, Patient Access or Manager, Patient Access

Job Code: Varies

FLSA: Non-exempt

Pay grade: SO_TH_06

SO_TH_07

SO_TH_08

Varies

Purpose

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

Essential Functions

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.

Minimum Qualifications

High school diploma or equivalent.

HFMA CRCR or NAHAM CHAA required within one (1) year of hire.

Additional Qualifications (nice to have)

Medical terminology required & knowledge of diagnostic & procedural coding

Insurance verification with the ability to explain benefits, secure necessary authorizations

Physical & Mental Requirements & Working Conditions

Direct Healthcare Services / Indirect Healthcare / Support Services: Exposure to conditions which may be considered unpleasant to sight, touch, sound & / or smell. Occasional Exposure to fumes, odors, dusts, mists & gases, biohazards / hazards (mechanical, electrical, burns, chemicals, radiation, sharp objects, etc.). Occasional Exposure to or subject to noise, infectious waste, diseases & conditions. Occasional Exposure to interruptions, shifting priorities & stressful situations. Frequent 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. Continuous 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. Continuous Perform manual dexterity activities & / or grasping / handling. Frequent Ability to climb, kneel, crouch & / or operate foot controls. Occasional Use a computer / other technology. Continuous Sit with the ability to vary / adjust physical position or activity. Continuous Maintain a safe working environment & use available personal protective equipment (PPE). Frequent Comply with Trinity Health’s Code of Conduct, policies, procedures & guidelines. Continuous Ability to provide assistance in the event of an emergency. Occasional

Direct Healthcare Services: Perform activities that require standing / walking with the ability to vary / adjust physical position or activity. Occasional Lift a maximum of 30 pounds unassisted. Occasional Use upper & lower extremities, engage in bending / stooping / reaching & pushing / pulling. Frequent Work indoors (subject to travel requirements) under temperature-controlled & well-lit conditions. Continuous Encounter worksites (e.g., patient homes) or travel to worksites that may have variable internal & external environmental conditions. Occasional

Perform work that involves physical efforts (e.g., transporting, moving, positioning & / or ambulating patients). Occasional

Indirect Healthcare / Support Services: Perform activities that require standing / walking with the ability to vary / adjust physical position or activity. Occasional

Lift a maximum of 30 pounds unassisted. Occasional Experience of long periods of walking / standing / stooping / bending / pulling & / or pushing. Occasional Encounter a clinical / patient facing / hands on interactive work environment. Frequent

Location: Trinity Health Ann Arbor

Department: Registration

Status: Full Time 40 hours per week

Note: This is a fully on-site role

This position may be filled as a Patient Access level I or level II based on the prior work experience and matched qualifications of the selected incumbent.

Total Rewards and Benefits:

· Competitive compensation, DAILYPAY

· Benefits effective on Day One! No waiting periods.

· Full benefits package including Medical, Dental, Vision, PTO, Life Insurance, Short and Long-term Disability

· Retirement savings plan with employer match and contributions

· Colleague Referral Program to earn cash

· Unlimited career growth opportunities with one of the largest Catholic healthcare organizations in the country

· Tuition Reimbursement

Position Purpose:

Provides patient focused customer service within the Emergency Department. 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, and physician offices.

Note: “patients” refers to patients, clients, residents, participants, customers, members

Minimum Qualifications:

· High School diploma or GED required.

· HFMA CRCR or NAHAM CHAA required within one (1) year of hire.               

Essential Functions:

· Research, collect, and analyze information.

· Identify opportunities, develop solutions, and lead 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, and develop educational materials.

· 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 and demonstrate progress, ROI, and 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 to ensure adherence in a manner that reflects honest, ethical & professional behavior & safe work practices.

Work Conditions

· Exposure to conditions which may be considered unpleasant to sight, touch, sound & / or smell. Exposure to fumes, odors, dusts, mists & gases, biohazards / hazards (mechanical, electrical, burns, chemicals, radiation, sharp objects, etc.).

Exposure to or subject to noise, infectious waste, diseases & conditions. Occasional

· Exposure to interruptions, shifting priorities & stressful situations. Frequent

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. Continuous

· 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. Continuous

· Sit with the ability to vary / adjust physical position or activity. Continuous

· Maintain a safe working environment & use available personal protective equipment (PPE). Frequent

· Perform activities that require standing / walking with the ability to vary / adjust physical position or activity. Lift a maximum of 30 pounds unassisted. Occasional

· Use upper & lower extremities, engage in bending / stooping / reaching & pushing / pulling. Frequent

· Perform work that involves physical efforts (e.g., transporting, moving, positioning & / or ambulating patients). Occasional

Additional Functions of a Patient Access Rep II

· Performs all aspects of the Patient Access Rep I role & is cross trained & performs activities in Pre-Service, Emergency Department & / or Bed Desk

Required Qualifications of a Patient Access Rep II:

· Minimum of two (2) years of hospital registration or insurance verification experience.

· Knowledge of medical terminology, diagnostic coding, and procedural coding is required.

· Ability to explain insurance benefits.

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.