Patient Access Representative

Patient Access Services Representative

Assist 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.

Analyzes, evaluates, resolves and responds to service inquires from members, providers, employer groups, colleagues, agents, Elite agents (customers), and others within departmental guidelines. Professional and pleasant interactions are ongoing expectations.

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.

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.

All employees in all positions must :

• Adhere to Corewell Health's mission, vision, values, key strategies and policies.
• Ensure that services are provided in accordance with state and federal regulations, accreditation and compliance requirements, and organizational policy.
• Maintain reliable attendance and follow all call-in rules for the safety and welfare of our patients.
• Interact with co-workers, staff of other affiliates, patients, members and visitors in a positive and professional manner and communicate effectively and respectfully.
• Work as a team member helping others to contribute to the overall success of Corewell Health.

Satisfaction of these core expectations is considered an essential function of all positions at Corewell Health.

Education :

Experience :

Comprehensive benefits package to meet your financial, health, and work / life balance goals.

On-demand pay program powered by Payactiv

Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more!

Optional identity theft protection, home and auto insurance, pet insurance

Traditional and Roth retirement options with service contribution and match savings

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.

An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other.