Healthcare Customer Service Specialist

2 weeks ago

Ann Arbor, Michigan, United States Trinity Health Full time

Employment Type:
Part time
Shift: Day Shift
Overview:
Under minimal supervision, assesses the necessity for and secures authorization for treatments and procedures while managing benefit assignments. Provides patients with essential information regarding regulatory standards and outlines estimated costs along with patient financial responsibilities, aiding in the collection of co-pays, deductibles, and private pay balances.

Responsible for the thorough and precise collection of patient demographic and financial data to establish a patient-specific record for claims processing and to maintain an accurate electronic medical record.

Registers and checks in patients, determining initial patient and insurance liabilities. Conducts account analysis, troubleshooting, and resolution of patient account discrepancies. Initiates billing and rebilling processes as needed.
Interviews patients to gather information ensuring accurate and timely claims submissions.
Interprets collected data to create comprehensive billing records specific to each visit.
Secures necessary authorizations for treatments and procedures while managing benefit assignments as required.
Maintains proficiency by engaging in both onsite and external training opportunities, applying skills acquired from training to enhance work processes and customer interactions.
Provides patients with information regarding hospital policies and regulatory requirements, utilizing effective interpersonal and guest relations skills.
Assists other healthcare system or physician office staff with registration, insurance verification, and authorization processes.

Determines the appropriate payments required at the point of registration (including deposits, co-pays, minimum charges, and non-covered services) and collects payments during registration or check-out.

Based on anticipated services, provides estimated costs and patient responsibilities for both routine and complex services. Documents all communications with patients regarding estimates within the patient accounting record.

Verifies procedural and diagnosis codes submitted by service departments and physicians to ensure accuracy for claims submission and reimbursement adjudication.

Confirms insurance eligibility with payors, determines benefits, and ensures that authorization requirements are satisfied. Collaborates with ordering practitioners and patients to coordinate service and insurance needs.
Contacts patients to discuss eligibility, benefits, and requirements specific to clinical services. Creates appropriate registration records and communicates financial responsibilities, benefit statuses, and authorization details to patients prior to clinical services.

Facilitates cash collection as appropriate before and during service, including co-pays, deductibles, and private pay responsibilities.

Obtains insurance authorizations, patient liability acknowledgments, acknowledgments of non-covered services, and consent forms. Explains the purpose of these forms to patients and addresses any questions regarding their intent. Completes all necessary documentation, securing signatures and approvals while ensuring that all information is accurate and complete.

REQUIRED EDUCATION, EXPERIENCE AND CERTIFICATION/LICENSURE
Education:
High school diploma or equivalent required.

Experience:
One to two years of relevant experience preferred.

Certification/Licensure:
CHAA certification from the National Association of Healthcare Access Management is preferred.
REQUIRED SKILLS AND ABILITIES
Demonstrated experience with computerized systems. Strong critical thinking and problem-solving skills. Analytical abilities to effectively and efficiently resolve registration, insurance, and claims processing issues. Knowledge of revenue cycle processes and terminology.

Excellent interpersonal skills to communicate effectively with patients, team members, clinical colleagues, medical staff, third-party providers, and external agencies.

Exceptional customer service skills and a positive demeanor. Patience when dealing with diverse patient situations. Proficient in telephone communication.
Our Commitment to Diversity and Inclusion
Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation.

Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do.

Our colleagues possess varied lived experiences, customs, abilities, and talents. Together, we strive to be our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is 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, status as a protected veteran, or any other status protected by law.

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