Description
:The Detroit Medical Center (DMC) is a nationally recognized health care system that serves patients and families throughout Michigan and beyond. A premier healthcare resource, our mission is to help people live happier, healthier lives. The hospitals of the Detroit Medical Center are the Children's Hospital of Michigan, Detroit Receiving Hospital, Harper University Hospital, Hutzel Women's Hospital, the DMC Heart Hospital, Huron Valley-Sinai Hospital, the Rehabilitation Institute of Michigan and Sinai-Grace Hospital.
DMC's 150-year legacy of medical excellence and service provides patients and families world-class care in cardiovascular health, women's services, neurosciences, stroke treatment, orthopedics, pediatrics, rehabilitation, organ transplant and other general and specialty services.
DMC is a key partner in Detroit's resurgence, which continues to draw national and international attention. A dedicated corporate citizen with strong community ties, DMC is one of the largest and most diverse employers in Southeast Michigan.
Job Summary
Under general direction and according to established policies and procedures, answers incoming calls and initiates outbound calling for the assigned department to include physician/program/patient satisfaction surveys and pre-appointment/scheduling reminders. Provides tele-health services including, but not limited to, physician, diagnostic, program appointment scheduling, physician specialty consult line requests and educational classes/seminar schedules.
Responds to inquiries and/or refers the caller to the appropriate physician, department or program based on information provided by the caller. Identifies calls of a serious/urgent nature and directs them to an urgent/emergent care environment or Triage function as appropriate. Interprets customer needs and utilizes a computerized database to assist in arranging for resources to achieve customer satisfaction. Utilizes existing database marketing identifiers as a tool to aid the patient in more effectively achieving quality of life through enhanced/managed care assistance by properly identifying related support programs and treatment options.
Collects and verifies all necessary demographic insurance and related data. Verifies insurance coverage and benefit levels, obtains and analyzes necessary authorizations and referrals, and calculates estimated patient liability for call transactions.
Explains how to complete appropriate forms to patient and/or family to ensure the necessary consent forms and patient signatures are obtained. Provides financial counseling services to assist patients in identifying and obtaining payment sources. Completes charge entry, reviews, monitors and reconciles patient accounts to ensure accurate billing production.
Ensures compliance with third party payor requirements. Reconciles and corrects user specific reports. Establishes and maintains contacts with DMC representatives and physicians office staff in order to become familiar with their needs and concerns through the Physician Liaison Program.
Generates database, word processing and spreadsheet marketing reports. Maintains patient service records and conducts routine database profile updates, data management/accuracy audits, and inter-departmental synchronizing of frequently changing information. Participates with other members of the department in continuous quality improvements that lead to achieving and sustaining high levels of customer satisfaction. Acts as a community liaison through participation in DMC sponsored health initiatives.
Qualifications
:1. High school diploma or equivalent. Two to five years of college level course work and/or related experience in health care field preferred.
2. Two years of experience with direct patient and/or physician contact in a clinical or administrative setting, or at least one year of experience with direct patient and/or physician contact in a clinical or administrative setting working with the same software program and customer base as the DMC Call Center.
3. Two to five progressive years of work experience in insurance, medical record, billing or related area preferred.
