The Med Inn Sleep Clinic is seeking a Patient Services Intermediate candidate to provide referral and authorization management support in an ambulatory care setting serving an adult and pediatric patient population. The successful candidate will coordinate and facilitate communications regarding authorization for sleep studies and outpatient clinic services among primary care physicians, managed care plans, specialists, clinic personnel, and patients.
Obtain, process, and track insurance referrals and authorizations for Pediatric/Adult Sleep patients using the MiChart System.
Obtain authorizations, pre-certifications and benefit level verification from third parties for scheduled appointments.
Build and maintain excellent rapport with internal and external primary care sites.
Serve as liaison between primary care physicians, specialist, and patients in the referral approval process.
Serve as a resource for physicians, office staff, patients, and outside third parties for managed care authorizations and other managed care related contract issues.
Maintain a large scope of knowledge regarding insurance plans, requirements, and expectations in an ever changing environment.
Maintain authorization files for clinics including data entry of referrals and monitor work lists.
Obtain retro referrals/authorizations and/or having referrals/authorizations altered to meet the service rendered.
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.
Connect patients to Patient Financial Counselor to receive financial counseling regarding financial responsibilities for services to be given.
Attend monthly revenue cycle coordinator meeting. Bring back information to share with office staff.
Performs charge entry in MiChart on all sleep studies performed.
Assigns modifiers, diagnosis codes, and CPT procedural codes to professional and facility charges utilizing provider documentation.
Proactively identify and resolve billing issues.
Verify that cost centers and providers are appropriately reported.
Act as on site specialist to answer charge entry questions to front desk staff.
Mentor, orient, and support new staff and assist with on-the-job training
Other duties as assigned.
High school diploma or GED
3 to 4 years of related experience
Knowledge of basic medical terminology
Excellent interpersonal and communication skills including the ability to interact in a professional and courteous manner with a diverse population
Ability to adhere to high standards of teamwork by demonstrating adaptability, flexibility, and consistently sharing information and resources with others
Candidate must demonstrate organizational and problem solving skills, proficient computer and keyboarding skills, and excellent attendance
Demonstrate dependability, initiative, and ability to accept direction
Proficient in Microsoft Word, Excel, and Outlook
Experience in an ambulatory care clinical setting
Experience working within a large, complex health care setting
Knowledge of Michigan Medicine software such as MiChart & Aspect
Knowledge of Michigan Medicine policies and procedures
Monday through Friday daytime hours
Michigan Medicine 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. Pre-employment drug testing applies to all selected candidates, including new or additional faculty and staff appointments, as well as transfers from other U-M campuses.
Michigan Medicine 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.