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BUSINESS OFFICE COORDINATOR - METRO HEALTH
* Grand Rapids, MI
* Mary Free Bed Rehabilitation Hospital
* Metro - Outpatient
* On-Call/Resource - Days - 7:30a-5:00p; hours vary
* Administrative
* Posted: November 12, 2018
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We have the great privilege of helping patients and families re-build their lives. It s extraordinarily meaningful work and the reason we greet the day with optimism and anticipation. When patients Ask for Mary, they experience a culture that has been sculpted for more than a century. Our hallmark is to carefully listen to patients and innovatively serve them. This is true of every employee, from support staff and leadership, to clinicians and care providers.
Mary Free Bed is a not-for-profit, nationally accredited rehabilitation hospital serving thousands of children and adults each year through inpatient, outpatient, sub-acute rehabilitation, orthotics and prosthetics and home and community programs. With the most comprehensive rehabilitation services in Michigan and an exclusive focus on rehabilitation, Mary Free Bed physicians, nurses and therapists help our patients achieve outstanding clinical outcomes. The growing Mary Free Bed Network provides patients throughout the state with access to our unique standard of care.
Mission Statement
Restoring hope and freedom through rehabilitation.
Diversity and Inclusion
Mary Free Bed values diversity and inclusion among patients, families and staff. We strive to hire people who reflect the communities we serve. Our employees will serve all patients, families and each other with dignity and respect.
Summary
Accurately collects information from multiple sources to process referrals for outpatient therapy. Analyzes and records the required demographic, insurance, and clinical data sets, other information, and signatures necessary to schedule and pre-register outpatient therapy patients and ensure that bills are produced according to regulatory and payer requirements. Effectively completes medical necessity and managed care requirement screening, and determines insurance type and eligibility to ensure maximum payer compliance is maintained and maximum reimbursement is secured. Verifies and/or authorizes insurance as assigned. Interacts in a customer focused manner during referral processing to ensure that the patient s and their representative s needs are met, and that they understand their personal liabilities through various payment and program options. Demonstrates complete understanding and knowledge of all processes and procedures related to insurance verification, insurance prior authorization, and registration. Performs all insurance verification and communicates appropriate verbal and written explanations to patients, family members, and/or other appropriate parties. Assists in prevention of retroactive denials. Works cooperatively with other departments and outpatient staff/leadership to assure financial reimbursement for outpatient therapy services.
Essential Job Responsibilities:
* Accurately collects and analyzes all required demographic, insurance, guarantor and clinical data elements necessary to process/pre-register outpatient therapy referrals and schedule all types of patients; records and electronically enters the information on a timely basis. Verifies and/or authorizes insurance.
* Accurately prepares, produces, and distributes to other internal and external parties as appropriate and on a timely basis, forms, schedules, and supportive clinical documentation.
* Reviews physician referrals/orders and other documentation according to internal policy and regulation as applicable, in order to assure that the service being provided has been appropriately documented and meets all known payer medical necessity and other criteria. Initiates contact to physicians and other office staff to resolve questions and problems. Initiates and explains the Advance Beneficiary Notification process as necessary. Alerts appropriate parties for any ongoing monitoring or authorization needs.
* Enters calculated expected patient co-pay and co-insurance amounts in Cerner. Sets follow-up dates in Share Point to monitor out-of-pocket maximums to determine amounts met.
Mary Free Bed is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, age, genetic information, veteran status, disability or other legally protected characteristic.
Employer's Job# 6413-3577
Please visit job URL for more information about this opening and to view EOE statement.
