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.
Mission Statement
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 Summary
Under general supervision of the director, performs and oversees multiple functions to support the enterprise-wide centralized authorization and financial clearance department's adherence to payor coverage and authorization requirements. Formulate and define process scope and objectives through workflow documentation, research and fact-finding of applicable business operations, business systems and industry standards. Work with clinical departments, HITS and Revenue Cycle to develop or modify systems to accommodate moderately complex insurance processes. Identify and document any gaps with the current workflow processes and technology and make process improvement recommendations. Create and document new workflows that are patient-centered, eliminate waste and closes gaps on front end operations based on back-end knowledge and analysis. Perform testing and education related to new features and upgrades for authorizations and financial clearance. Monitor and analyze results to ensure positive outcomes.
Responsibilities*
- Develop a comprehensive, cross-functional understanding of business processes, production systems, enterprise-wide data warehouses/sources and departmental databases related to insurance authorizations
- Perform business analysis, technical evaluation, and documentation of duties for authorization and financial clearance processes.
- Work closely with clinical areas, Revenue Cycle, Coding, Contracting, CDSs, RQLs and other operational areas/roles to understand business and user needs.
- Create project plans that document business requirements, scope documents and standard operating procedures, develop testing scripts and timelines
- Stay current on authorization and surprise billing requirements as it relates to healthcare.
- Investigate and resolve issues for staff related to authorizations; analyze issues to isolate specific operational and technical problematic component(s).
- Research best practices for authorizations and financial clearance; share information and assist leadership in developing best practices.
- Identify and implement process improvements related to authorizations and financial clearance; define prioritization process for authorization project requests.
- Complete root cause analysis on authorization related denials and write-offs; prepare, analyze and present reports to track and identify trends; make recommendations for process improvement based on the findings.
- Support Revenue Cycle in maximizing the use of standardized workflows
- Promote a patient centered financial advocacy environment.
- Track and assist in resolution of denials and no-authorization write-offs
- Guides and advises less-experienced Business Systems Analysts
- Perform special project and other duties as assigned
Required Qualifications*
- A Bachelor's degree in Information Technology, Business Administration, Health Care Administration or related field, or an equivalent combination of education and/or experience is necessary.
- 2-3 years? experience in a centralized authorization unit within a healthcare setting. Ability to perform business analysis.
- Demonstrated ability to work independently and collaboratively with teams of all sizes.
- Strong computer skills and ability to adapt to new technology.
- Outstanding organizational skills and ability to prioritize multiple tasks with competing deadlines is required to effectively work to meet deadlines.
- Effective interpersonal and communication skills.
- Knowledge and experience with MiChart.
- Front-end clinical experience with authorizations.
- Ability to troubleshoot and resolve problems, provide user support, create reports, and communicate to management.
- Must be proficient in workflow documentation software such as Microsoft Visio etc.
Desired Qualifications*
- Experience working across UMHS departments to gather requirements and define business needs for system application build and support.
- Current Coding certification (CPC) preferred.
- Knowledge of MiChart Billing.
- Understanding of Lean principles and practices.
- Project management skills strongly desired.
- Epic certification a plus.
Why Join Michigan Medicine?
Michigan Medicine is one of the largest health care complexes in the world and has been the site of many groundbreaking medical and technological advancements since the opening of the U-M Medical School in 1850. Michigan Medicine is comprised of over 30,000 employees and our vision is to attract, inspire, and develop outstanding people in medicine, sciences, and healthcare to become one of the world?s most distinguished academic health systems. In some way, great or small, every person here helps to advance this world-class institution. Work at Michigan Medicine and become a victor for the greater good.
What Benefits can you Look Forward to?
- Excellent medical, dental and vision coverage effective on your very first day
- 2:1 Match on retirement savings
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.
Work Locations
This position is a remote position where you will work from home/virtually once training is completed and performance-based competency has been obtained. High speed internet is a requirement for this position and the cost is the responsibility of the staff member. There may be occasions where the staff member may need to report to the business office location, including meetings, computer or technology requirements, or to complete work that is not possible to handle remotely. The business location will have space available to reserve onsite work when required or necessary. Although there is some flexibility in working hours, the business location and operations are in the Eastern Time Zone and work hours must accommodate interactions, including video conferencing, with colleagues during these hours. Computing resources including required software applications, VPN, desktop or laptop computer, monitor, webcam, keyboard and mouse, will be provided by the employer. Remote staff are not provided with a mobile phone but are provided with computer telephone and fax technology. Office equipment such as desk, chair, and printer are not provided. Basic supplies such as paper and pens, are stocked at the business location and are available to remote staff for pick-up should they choose. Unless otherwise agreed in advance with your manager, additional hardware, software, printing, and cost of office supplies preferred by the staff member, are the responsibility of the employee.
Technology Skills required include the ability to set-up computer and monitors and connect accessory items such as mouse, keyboard, and web cams. Remote computing support is available 24/7 via phone, chat, or ticketing system, to all staff members. Business Analyst will be expected to effectively communicate and resolve most computing issues directly with computing support resources.
Underfill Statement
This position may be underfilled at a lower classification depending on the qualifications of the selected candidate.
Background Screening
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.
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 any time after the minimum posting period has ended.
U-M EEO Statement
The University of Michigan is an equal employment opportunity employer.