How to Apply
To coordinate and facilitate communications between primary care physicians and managed care plans, specialists, Managed Care Operations, clinic personnel and patients regarding authorization for service and other insurance inquiries.
Characteristic Duties and Responsibilities
- Display excellent customer service skills with all communication and especially related to patients, physicians and staff.
- Serve as liaison between primary care physicians, specialists and patients in the referral approval process.
- Obtain authorizations, pre-certifications and benefit level verification from third parties for appointments scheduled in cardiology. Obtains add-on ECHO/testing authorizations in a timely manner.
- Monitors work queues on an on-going basis.
- Reviews ECHO testing work queues daily and schedules patient appropriately.
- Evaluate and process authorization requests, including communicating with patients and Plans, and obtaining authorization decision from the primary care physicians.
- Serve as resource for physicians and other staff, patients and outside third parties for managed care authorizations and other managed care related contract issues.
- Maintain authorization files for clinics including data entry of referrals and monitor work lists.
- Coordinate with central Managed Care Operations and clinic Patient Representatives.
- Assist with patient education related to the special requirements of Managed Care Plans. Perform other duties consistent with patient representatives of managed care patients.
- Respond to patient phone calls related to authorization concerns (i.e. patient receives a bill, ER authorizations, etc.).
- Facilitate scheduling of specialty services and schedule appointments as necessary.
- Direct patients to insurance carrier to address coverage and benefit questions related to appeals, when appropriate.
- Assist in policy design and evaluation as requested by Contracting Office/Managed Care Operations.
- May also be required to provide coverage to check-in and check-out staff, performing those typical responsibilities as needed.
- A high school diploma and/or equivalent combination of education and experience is necessary.
- 2-3 years' experience in a hospital business office, insurance office, physician's private practice or related setting is necessary.
- Exceptional interpersonal skills and ability to work well within a team setting.
- Communicates effectively.
- Demonstrates active listening, written, verbal and information technology skills.
- College course work in a health care/business field; an Associate’s degree is desirable.
- Reasonable knowledge of Hospital and departmental policies, procedures and regulations is desirable.
- Experience working with medical insurance companies and insurance authorizations is desirable.
- Knowledge of basic medical terminology.
- Experience working within a large complex health care setting.
- Familiarity with Michigan Medicine electronic medical records systems.
Work hours for this position are 8:00 a.m. - 5:00 p.m. Monday-Friday.
Cardiovascular Medicine Clinic at Domino's Farms.
University of Michigan Health System conducts background screening and pre-employment drug testing on job candidates upon acceptance of a contingent job offer and may use a third party administrator to conduct background screenings. Background screenings are performed in compliance with the Fair Credit Report Act.
The University of Michigan Health System improves the health of patients, populations and communities through excellence in education, patient care, community service, research and technology development, and through leadership activities in Michigan, nationally and internationally. Our mission is guided by our Strategic Principles and has three critical components; patient care, education and research that together enhance our contribution to society.
Job openings are posted for a minimum of seven calendar days. This job may be removed from posting boards and filled anytime after the minimum posting period has ended.
U-M EEO/AA Statement
The University of Michigan is an equal opportunity/affirmative action employer.