Patient Access Associate Representative

Shift and status

Full time, 9:00 a.m. to 5:30 p.m., variable days and every third weekend

Job Summary

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.

Essential Functions

• 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.
• Adheres to established procedure and quality guidelines in support of Priority Health service promise, key drivers, performance indicators, as well as Corporate values and codes of excellence. 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.
• Actively participates in safety initiatives and risk mitigating measures where appropriate and completes all position and unit safety related competencies and requirements on a timely basis.
• Performs other duties as assigned.

Qualifications

Required

• High School Diploma or equivalent
• 1 year of relevant experience

Preferred

• Associate’s degree

As part of our hiring process, you may be invited to complete an initial screening using an AI‑enabled voice agent. This screening focuses on job‑related qualifications and is reviewed by our hiring team as one part of the overall evaluation process. The voice agent provides the opportunity for applicants to respond at a time that works best for them.  The voice agent works 24/7 - just like healthcare!

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. 

How Corewell Health cares for you

• Comprehensive benefits package to meet your financial, health, and work/life balance goals. Learn more here.
• 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
• Traditional and Roth retirement options with service contribution and match savings
• Eligibility for benefits is determined by employment type and status

Primary Location

SITE - Care Center Breton - 4600 Breton Rd SE - Kentwood

Department Name

Contact Center Primary Care - Corporate

Employment Type

Full time

Shift

Day (United States of America)

Weekly Scheduled Hours

40

Hours of Work

9:00 a.