Patient Access Representative Associate

4 weeks ago

Grand Rapids, United States Corewell Health Full time

Patient Access RepresentativeAssist and educate patients, providers, medical office staff, and/or Health system staff with accessing services, facilitating and resolving problems, understanding navigation questions. Consistently create an exceptional experience with each contact, via inbound and outbound calls, online chat, email, etc. Adheres to established procedure and quality guidelines in support of Patient Access Services Center performance indicators, as well as Corporate values and codes of excellence.Essential Functions:Analyzes, evaluates, resolves and responds to service inquires from members, providers, employer groups, colleagues, agents, Elite agents (customers), and others within departmental guidelines.Partnering with internal and external resources, promptly provides customers with information and education concerning benefit clarification, eligibility requirements, verification, authorization, billing and claim status.Promptly identifies and resolves or escalates customer concerns or complaints to achieve positive outcomes.Places outbound welcome calls to members to educate them on their benefits as needed.Assists walk-in members and agents if assigned by leadership.Adheres to established procedure and quality guidelines in support of Priority Health service promise, key drivers, performance indicators, as well as Corporate values and codes of excellence.Identifies potential trends or issues that impact health plan members and works with coworkers and leadership resources to suggest process improvements.Assists customers with administrative issues, such as submitting enrollment record changes, providing letter explaining coverage or benefits, and obtaining and relaying certain member information to other departments as needed.Facilitates claims resolution through follow-up on member calls and correspondence received to appropriate departments.Effectively tracks and/or documents all service interactions with customers within appropriate systems according to guidelines.Develops and maintains behaviors of productivity, availability to customers, and adherence to work schedule.May be trained and then assigned to perform core scheduling duties for other service lines to meet fluctuating business demands.Qualifications:Required: High School Diploma or equivalentPreferred: Associate's Degree1 year of relevant experience in related fieldCorewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief.Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.

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