The Cardiac Procedures Unit at the Frankel Cardiovascular Center is currently seeking a Referral Coordinator/Authorization Specialist to coordinate and facilitate communications between primary care physicians and managed care plans, specialists, Managed Care Operations, clinic personnel and patients regarding services and other insurance inquiries.
- 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. Monitors work queues on an on-going basis.
- 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.
- Respond to patient phone calls related to authorization concerns.
- Direct patients to insurance carrier to address coverage and benefit questions related to appeals, when appropriate.
- Staff members are expected to exercise judgment in the application of the policies, procedures, and methods as well as screening patients' needs and setting work priorities.
- A high school diploma and 3-4 years of experience and/or equivalent combination of education and experience is necessary, supplemented by college course work in a health care/business field.
- Excellent phone etiquette skills.
- Ability to problem solve and provide solutions.
- Able to multitask.
- Understands and demonstrates the core concepts of Patient and Family Centered Care (PFCC), including: Respect and Dignity, Information Sharing, Participation, and Collaboration.
- Associate's degree in a health care and/or business field.
- Reasonable knowledge of Hospital and departmental policies, procedures and regulations.
- Experience working with medical insurance companies and insurance authorizations.
40 hours, full-time. Days, Monday through Friday. 8:30 a.m. to 5:00 p.m.
We, the staff and faculty of the U-M Cardiovascular Center (CVC) team, are committed to advancing medicine and serving humanity through living and teaching our core values of Respect and Compassion; Collaboration; Innovation; and Commitment to Excellence.
Each CVC employee is expected to understand and demonstrate that in every interaction we represent our entire organization in the care we provide and in the courtesies we extend to patients, families, and each respective team member. The CVC is dedicated to partnering with patients and families to deliver the safest and highest quality of health care. Applicants are expected to review the following PowerPoint presentation which provides an overview of the Cardiovascular Center's philosophy and culture:
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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.
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The University of Michigan is an equal opportunity/affirmative action employer.