Patient Management Clerical Associate Full Time Evenings Child Medicaid

Children’s Hospital of Michigan is an international leader in pediatric and adolescent medicine. Surgical services include general, thoracic, reconstructive and cardiovascular. Imaging technology designed specifically for children provides advanced diagnostic services including Positron Emission Tomography (PET) and MRI. The Children’s Hospital of Michigan Emergency Department is a verified Level 1 Pediatric Trauma Center and dedicated pediatric burn center. Experts in pediatric critical care, rehabilitation, and neonatal and perinatal medicine provide care for thousands of children every year at Children’s Hospital of Michigan, Children’s Hospital of Michigan - Troy and six ambulatory sites.

Job Summary

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.

Qualifications :

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.

Job : Patient Access / Admitting Primary Location : Detroit, Michigan Facility : DMC Children's Hospital of Michigan Job Type : Full Time Shift Type : Evening

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