Under general supervision, registers and schedules patients for health services ensuring appropriateness of setting for services provided. Obtains insurance, medical and/or demographic data to admit or pre-admit patients to the health facility. Verifies insurance coverage and benefit levels with various third party payers. Assists patients without medical insurance coverage in completing medical assistance applications and/or making payment arrangement. Collects cash for deductibles and coinsurances, per insurer guidelines. Participates in bed management activities as defined in operating unit policies and procedures. Functions as liaison between patient and health facility by answering patients questions regarding health facility policies and billing requirements and by obtaining necessary information to efficiently register and accurately bill for services rendered. Assists patients in completing necessary forms and obtains patient signature as dictated by facility policies and procedures. Collects referrals and authorizations; facilitates securing referrals and authorizations from referring providers as necessary. Performs pre-registration and pre-admission activities via telephone prior to service. 1. Greets or contacts patient; collects and verifies all necessary demographic insurance and related data. Ensures that consent and other required forms are completed correctly, and patients/guardians signatures are obtained where required. 2. Schedules appointments, generates appointment notices, reschedules and posts cancellations; determines appropriate service settings in accordance with established policies and procedures; and resolves scheduling issues in conjunction with appropriate providers and ancillary departments. Coordinates scheduling of all tests and/or services utilizing current clinical guidelines. 3. Verifies insurance coverage and benefit levels; secures authorizations and referrals; assesses patient liability amounts. 4. Provides financial counseling services to assist patients in identifying and obtaining alternate payment sources. 5. Reviews, monitors, and reconciles collected demographic and insurance data in order to ensure accurate bill production. Ensures compliance with third party payer requirements. 6. Reconciles and corrects rejected erroneous data transactions as displayed on Transmission, Control and Errors (TCE) reports. 7. Accesses computerized system to enter and/or update electronic systems as needed and to answer patients, stakeholders and other pertinent parties inquiries. Responds to general inquiries as required. 8. Maintains patient service records and performs related duties as requested. 9. Participates in bed management as defined by operating unit policies and procedures. 10. Communicates clinical, financial, and administrative information. 11. Performs other duties as assigned. 12. Assists nursing and technical staff in screening patients and performs a variety of moderately to highly complex patient registration duties. 13. Interacts with technologist and radiology nursing staff; interacts with customers/stakeholders to provide/distribute appropriate exam results in a timely and accurate manner; maintains patient charts and films as appropriate.
1. High school diploma or equivalent. 2. One to two years work experience in hospital healthcare insurance, medical records, billing or related area desirable. 3. Working knowledge of medical terminology desired. 4. A strong commitment to the DMC customer service standards. Additional qualifications when assigned to Radiology: 5. On the job training or related previous experience to acquire skills in screening and preparing patients for exams. Some college preferred. 6. Six to twelve months of related computer/information management experience required.
Primary Location: Detroit, Michigan
Facility: DMC Children's Hospital of Michigan
Job Type: Full-time
Shift Type: Days
Employment practices will not be influenced or affected by an applicantâ��s or employeeâ��s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.
Internal Number: 1905050293
About DMC Children's Hospital of Michigan
“Tenet Healthcare Corporation is a diversified healthcare services company with 115,000 employees united around a common mission: to help people live happier, healthier lives. Through its subsidiaries, partnerships and joint ventures, including United Surgical Partners International, the Company operates general acute care and specialty hospitals, ambulatory surgery centers, urgent care centers and other outpatient facilities. Tenet's Conifer Health Solutions subsidiary provides technology-enabled performance improvement and health management solutions to hospitals, health systems, integrated delivery networks, physician groups, self-insured organizations and health plans.