Job Summary

Under general direction of the Patient Access Manager - Benefits Advisor, this position is responsible for assisting uninsured and underinsured patients and their families in researching and securing potential funding for services provided; including but not limited to Medicaid, Medicare SSI, and any other federal, state, Corewell Health based, grants, and local programs, marketplace, auto, and other 3rd party liability payers. Performs duties at acute hospital sites, and ambulatory sites. Utilizes knowledge of billing and payer rules to facilitate determination of potential resources and seamless processing of paperwork. Works with Corewell Health staff and other providers to recommend referral of patients to appropriate sites for care.

Essential Functions

• Manages the process to ensure that all Benefit Advisors are educated and trained in identifying patients who are uninsured and underinsured. Offers alternatives and assists with application process for Medicaid, Health Michigan, Financial Assistance and Marketplace exchange plans. Works with third party vendors on complex cases as directed by department policy.

• Advises patients and/or family members of their financial obligation via all modes of communication, including face-to-face communication while in the facility.

• Obtains payment in full or secures adequate payment arrangements/eligibility and benefit information for both inpatient and outpatient services. Advises patients on expenses associated with admission. Secures payments or payment arrangements on self-pay accounts. Discusses third party coverage with patient and arranges disposition of out-of-pocket balances due. Informs patients of payment requirements as soon as possible for inpatient preferably prior to discharge.

• Advises patients as to their financial liability and assists with insurance issues and activation of coverage.

• Administers collection program on international and cosmetic patients as directed per hospital policy to collect pre-payments.

• Utilizes Charge Master, EPIC price estimator, and business tools to provide cost estimates for complex procedures, surgeries, and ancillary testing and ensures information is received from patients and physicians.

• Provides superior customer service to the patient and family by assisting with completion of required paperwork and program applications, such as for Medicaid and the Corewell Health Charity and Financial Assistance Programs.

• Serves as a resource to Patient Accounting staff, Social Workers, and other staff for identification of funding sources for health services for patients.

• Explains and assists with all discount programs as they relate to the patient’s financial responsibility.

• Communicates with other institutions relative to any prior patient service.

• Attends hearings at the state and local level, as needed.

• Assists with the discharge process to extended care facilities as it relates to the patient’s financial responsibility.

• Identifies hospital, public, and / or private financial assistance programs for patients unable to meet their financial obligations. Collaborates with Social Services, clinical staff, and / or outsourcing company to assist patients / families in completing assistance program applications and determining eligibility and coverage. Inputs data into electronic database(s) and completes daily reports timely and accurately.

• Documents all activities with patients, families, insurers, D.H.S. workers and providers regarding financial assistance needs.

• Continually works with management in Business Operation Support to improve the efficiency of data collection as well as ALL customer satisfaction.

• Provides departments with ongoing feedback to ensure compliance with third party payer regulations.

• Interacts with other third-party vendors, and Case Management, Detroit Wayne County Health Authority, and D.H.S. workers to assure a timely, efficient, and accurate financial case.

• Attends department staff meetings and in-services to maintain current knowledge. Keeps up to date with all department standards to assure compliance with state and federal regulations. Responsible for training new employees and instructing current employees of process changes.

• Special projects as assigned.

How Corewell Health cares for you

• Comprehensive benefits package to meet your financial, health, and work/life balance goals. Learn more here (https://careers.corewellhealth.org/us/en/benefits-new) .

• 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

• Relocation assistance (OPTIONAL)

Qualifications

Required

• Required High School Diploma or equivalent.

• Experience working with the public.

Preferred

• 2 years of relevant experience 2-3 years’ experience working with government entitlement programs (e.g., Medicaid) in a previous financial counseling or third-party billing role.

• Previous Medicaid application processing experience highly desirable.

• Six to ten years of patient accounting, medical billing, or non-clinical healthcare experience preferred. Knowledge of ICD-9 coding.

About Corewell Health

As a team member at Corewell Health, you will play an essential role in delivering personalized health care to our patients, members and our communities. We are committed to cultivating and investing in YOU. Our top-notch teams are comprised of collaborators, leaders and innovators that continue to build on one shared mission statement - to improve health, instill humanity and inspire hope. Join a nationally recognized health system with an ambitious vision of continued advancement and excellence.

Primary Location

SITE - Beaumont Service Center - 26901 Beaumont Blvd

Department Name

Financial Counseling

Employment Type

Full time

Shift

Weekly Scheduled Hours

40

Hours of Work

Variable

Days Worked

Monday to Friday

Weekend Frequency

N/A

CURRENT COREWELL HEALTH TEAM MEMBERS – Please apply through Find Jobs from your Workday team member account. This career site is for Non-Corewell Health team members only.

Corewell 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.

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. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team.

You may request assistance in completing the application process by calling 616.486.7447.

People are at the heart of everything we do, and the inspiration for our legacy of outstanding outcomes, innovation, strong community partnerships, philanthropy and transparency. Corewell Health is a not-for-profit health system that provides health care and coverage with an exceptional team of 60,000+ dedicated people—including more than 11,500 physicians and advanced practice providers and more than 15,000 nurses providing care and services in 22 hospitals, 300+ outpatient locations and several post-acute facilities—and Priority Health, a provider-sponsored health plan serving more than 1.2 million members. Through experience and collaboration, we are reimagining a better, more equitable model of health and wellness.