Referral Representative - Inpatient at Mary Free Bed Rehabilitation in Grand Rapids, Michigan

Job Description:

Essential Job Responsibilities:

• Prioritize inpatient referrals based on tentative admission dates, payer type and referral source.


• Perform eligibility and benefit verification of identified insurance coverage for each inpatient referral. Initiate electronic and/or telephone inquiries to the appropriate parties including third party payers, employers, and/or managed care organizations, sharing information as necessary in order to secure, record, and electronically enter data confirming patient has benefits for inpatient rehabilitation. Communicate need to pre-certify admission to Utilization Review/Reimbursement Coordinator.


• Analyze the available documentation and use software and/or other listings or information, including the data gathered during the third-party eligibility and benefit verification, in order to calculate the amounts expected to be received from the payer and the amount owed by the patient or his/her responsible party.


• Meet with each new inpatient after admission to review and verify patient data and insurance information and consents.


• Provides information to patients on Patient Rights, Advance Directives, Notice of Privacy Practices, Medicare Patient Appeal Rights, and other required documents.


• Accurately generates patient specific Benefit Summary Forms, updating benefit information as needed, and distributes to patient/representative and appropriate internal parties on a timely basis. Help insured patient navigate their eligibility and benefits and help un-insured/under insured patient access programs that can assist them by referring them to MFB's IP Financial Counselor.


• Update Access Management Registration with any changes. Scan signed registration packet documentation into EMR.


• Begin CFA review process to preliminarily determine patient eligibility and give an estimate of possible award level.


• Act as support staff for the IP Financial Counselor as needed

Customer Service Responsibilities:

Demonstrates excellent customer service behaviors consistent with organizational and departmental standards. Consistently promotes teamwork and direct communication with co-workers. Deals discretely and sensitively with confidential information.

Responsibilities in Quality Improvement:

Contributes by identifying problems and seeking solutions. Promotes patient/family satisfaction where possible; participates in departmental efforts to monitor and report customer service.

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.

Essential Job Qualifications (Knowledge, Education, and Training Requirements):

• Associates Degree or equivalent business classes/medical office experience


• Understanding of medical terminology and clinical rehabilitation


• Time management skills to handle multiple, competing demands and priorities and work effectively under pressure.


• Strong, effective organization and interpersonal skills, oral and written.


• Collaborative team style and open communication, including with other departments.


• Ability to work independently as well as in a group.


• Excellent analysis and problem-solving skills.


• Demonstrated commitment to organizational mission with a "whatever it takes" attitude to get the job done.


• Credible and trustworthy.


• Intermediate knowledge of Microsoft Office Suite (Word, Excel, PowerPoint).


• Physical Demands: Able to exert up to 10 pounds of force occasionally (up to 1/3 of the time); able to lift, carry, push, pull, up to 10 pounds occasionally; able to sit for the majority of the time, but may involve brief periods of time walking or standing; able to use keyboard frequently (1/3 to 2/3 of the time)

Other Preferred Job Qualifications:

• Three to five years' hospital medical billing experience


• 12 to 18 months hospital medical billing experience


• In-depth knowledge of payer billing regulations


• IRF medical billing experience


• Knowledge of ICD-9-CM and CPT coding classification systems

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.