Patient Access Associate Representative

Shift and Status

Full time, Monday to Friday, 8:00 a.m. to 4:30 p.m.

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.

• Analyzes, evaluates, resolves and responds to service inquiries 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 regarding 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 letters 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.

• 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!

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.