Patient Business Associate

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How to Apply

A cover letter is required for consideration for this position and should be attached as the first page of your resume. The cover letter should address your specific interest in the position and outline skills and experience that directly relate to this position.

Job Summary

Department Summary:

The University of Michigan (UM) University Health Service (UHS), is an ambulatory, multispecialty health clinic within Student Life. We serve a large and diverse student body of more than 45,000 students, as well as eligible UM faculty and staff. UHS provides clinical services throughout our primary care and specialty clinics, as well as health and wellness education and promotion. Through our programs, services and partnerships, we foster lifelong learning in support of individuals to become active participants in their health and wellbeing.  This position is conveniently located on campus near downtown Ann Arbor and minutes from Michigan Medicine.


Position Summary:

The Administrative Division supports the infrastructure of our UHS workflows and processes. Our Campus Insurance unit is responsible for the administration of the U-M Domestic Student Health Insurance, the U-M Tuition Refund Insurance and the U-M Travel Abroad Health Insurance plans. We provide exceptional customer service as liaisons between clients, clinical staff members, University Departments, outside medical providers and health insurance companies. The Campus Insurance Office provides assistance in coverage and benefit interpretation, obtaining referrals and authorizations, and supporting continuity of care. Our team assists with the coordination of patient visits and procedures, including service requisitions, interfacing with our billing partners, medical providers in Michigan (MI) and throughout the country as needed. We work to ensure and enable a smooth transition of care, including information and education about covered benefits, treatment needs and the patient and insurer's financial responsibilities for specific services. 

Responsibilities*

Liaison and Consultation: 65%

  • Respond to inquiries received through phone, mail, email or zoom from patients, providers, U-M departments or insurance providers.
  • Research individual patient coverage and benefits detail via payor websites, direct contact with company representatives, insurer's Certificates of Coverage, Benefits at a Glance documents, Member Guide documents, fee schedules & other benefit information.
  • Provide coverage and benefit details related to each company's products or services using insurer's Certificates of Coverage and Member Guides and procedures. Act as liaison between patients, clinicians, billing offices, University Departments, U-M employee benefit plans, International and Domestic student insurance company, the U-M Tuition Refund Insurance, the U-M Travel Abroad Insurance plans and other health insurance companies and provide detail for all inquiries.
  • Support UHS Patient Business Office in providing patient liability estimates using procedure cost, procedure codes, diagnosis and insurer's certificate of coverage. Seek additional advice and assistance from the UHS Billing Office, the Michigan Medicine (MM) Billing Office and MM Patient and Financial Counselors for complex cases.
  • Educate patients about insurance benefits and financial responsibilities for hospital and professional services for current members before receiving services or for prospective members trying to decide on a health insurer.
  • Research members' questions about medical bills they have received, including charges that should have been covered by insurance and overdue member balances.  Review charges with members, service providers, and health insurers and assist with correcting claims.
  • Provide direction and coverage information to participating and non-participating medical provider offices (including referral coordinators, authorization departments, and check-in staff) regarding member co-payments, co-insurances, referrals, authorizations, and insurer payments, as requested.
  • Pursue alternative funding sources for patients, assist or advise in completing appropriate screening forms, including coaching and assisting clients on university and outside financial resource options, including MI Medicaid insurance eligibility and enrollment.
  • Review and analyze medical record information, including but not limited to past therapies, review of prescription history to assist insurers in approval/authorization for high-cost services such as surgery, CT, MRI or PET scans).
  • Evaluate medical documentation, including medical chart notes, and obtain additional support documents if needed for entering electronic 'Global Referrals' for members with BCN coverage.
  • Negotiate with insurance providers to obtain approval for the expansion of insurance benefits to cover service needs.
  • Consult with MM Care Managers on assisting uninsured or underinsured patients.

Administrative Functions: 35%

  • Create and maintain activity logs, compile data, and provide reports on a regular cadence.
  • Assist other Managed Care/Student Insurance staff as available.
  • Assist in the coordination of care, including advice regarding alignment of patient visits, procedures, radiology/imaging, and diagnostic/therapeutic studies.
  • Support scheduling alignment, complete service requisitions, and complete special service diagnostic/medical information requests from providers and insurance companies. Support any necessary documentation, including insurance referrals and authorizations.
  • Assist patients with urgent and emergent referrals to outside facilities.
  • Evaluate the type of service requested and the urgency of identified problems for referrals.
  • Monitor provision of scheduled non-UHS services, which may include obtaining and providing results/notes to the ordering clinician.

Required Qualifications*

  • High school diploma or GED
  • Minimum of 2 years of administrative experience in a healthcare delivery system, health insurance, or related field
     

Desired Qualifications*

  • Familiarity with Availity, EReferrals and MiChart.
  • Knowledge of third-party reimbursement, policies and procedures.
  • Proficiency in MiChart, Outlook, Microsoft Word, Excel, PowerPoint, Google software, Zoom.
  • Experience working with an Electronic Medical Record (EMR), preferably MiChart.
  • Experience with medical terminology and human anatomy.
  • Knowledge of University of Michigan policies and procedures.
  • Familiarity with ICD-10 coding.
  • Knowledge of UHS policies and procedures.
  • Bi-lingual or multi-lingual skills.
     

Modes of Work

Positions that are eligible for hybrid or mobile/remote work mode are at the discretion of the hiring department. Work agreements are reviewed annually at a minimum and are subject to change at any time, and for any reason, throughout the course of employment. Learn more about the work modes.

Additional Information

Position Responsibilities Criteria (leadership and behavioral qualities expected in this position):

  • Demonstrated excellent interpersonal communication skills.
  • Demonstrated history of professional etiquette and reliability.
  • Demonstrated ability to maintain privacy and discretion.
  • Ensures that customers receive the best possible service.
  • Ensures coordination with each member of the care team as needed.
  • Demonstrated excellent writing and problem-solving skills.
  • Demonstrated ability to work independently as well as within a team.
  • Demonstrated ability to multi-task and set priorities, working independently or with minimal supervision.
  • Demonstrated experience using Microsoft Office software (Word, Excel, PowerPoint).

Financial/Budgetary Responsibility:

  • Work with Student Life Budget & Finance staff, related to monthly statement review of usual expenses. Budgets are renewed annually on Fiscal year: July 1 - June 30.

Working Conditions:

  • This role involves consistent office/desk work and may be substantially remote. Standards of practice for patient services offered by staff within this job family have the potential to include care offered via telehealth.

Physical Requirements:

  • For the most part, this role is at a desk handling the phone.

Direct Reports:

  • N/A

This role may have reporting obligations under Title IX and Clery.  

Authorization to work in the U.S. is a precondition of employment and applicants for this position will not be sponsored for work visas.  

Salary may vary depending on qualifications, experience, and education of the selected candidate.

Selected candidates whose start date is 4/1/2025 or after, will not be eligible for the university FY25-26 salary/merit plan unless otherwise notified.

Relocation will not be offered for this position.

#studentlife
 

Application Deadline

Job openings are posted for a minimum of seven calendar days.  The review and selection process may begin as early as the eighth day after posting. This opening may be removed from posting boards and filled anytime after the minimum posting period has ended.

U-M EEO Statement

The University of Michigan is an equal employment opportunity employer.