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.
To perform member services, administrative and fiscal activities of moderate complexity with moderate authority to make commitments on behalf of University Health Service.
Be an integral part of our Managed Care team. Provide exceptional customer service as a liaison between clients, clinical staff members, University Departments and health insurance companies, providing referrals, obtaining authorization, documenting health care activities and interpreting coverage for client needs. Coordinate patient visits and procedures including scheduling appointments and completing service requisitions. Review and analyze medical record information and obtain Third Party Administrator approval/authorization for further treatment.
Appointment Scheduling – 65%
Coordinate patient visits, procedures, radiology/imaging and diagnostic/therapeutic studies, scheduling the appointment, completing service requisitions, completing special service diagnostic/medical information requests from providers and insurance companies, providing and creating necessary documentation including insurance referrals and authorizations. Pre-register patients at outside facilities.
Determine appropriate provider to order service from, evaluating type of service requested and urgency of problem.
Monitor provision of scheduled non-UHS services, obtaining and providing results/notes to ordering clinician.
Correspond with patients and clinicians on scheduling process and results.
Assist patients with scheduling problems and/or services issues.
Member Service – 30%
Act as liaison between clients, clinical staff members, University Departments, Prescription Benefit Managers, Blue Care Network and other University Plans, International and Domestic student insurance companies and other health insurance companies, providing referrals, obtaining authorization, documenting health care activities and interpreting coverage for client’s needs, level of care, payment tiers, and reimbursement options. Coach and assist clients on financial resource options.
Act as a liaison between UHS patients (students, faculty, staff, retirees, spouses and dependents), UHS clinicians, University Departments, Domestic/International student insurance, and faculty/staff and other insurance companies regarding health care coverage/benefit interpretation.
Review and analyze medical record information, including but not limited to past therapies, reviewing prescription history and obtaining Third Party Administrator approval/authorization of further treatment.
Perform administrative and fiscal activities of moderate complexity with limited authority to make commitments on behalf of the department/UHS within defined guidelines.
Negotiate with case managers to obtain approval for expansion of insurance benefits to cover service typically not a benefit of the insurance.
MI Medicaid Eligibility and Enrollment assistance for UM Students.
Evaluate, compile medical documentation, review medical chart notes and obtain additional support documents from non-UHS facilities, creating letters of medical necessity for approval, identify exceptions and document special conditions for Medical, DME and Prescription coverage for benefits of out of service area with providers and non-par providers.
Create and maintain activity logs, compile data and provide reports.
Analyze medical documentation coding with appropriate national codes.
Assist other Customer Service Representatives, as needed.
Policy and Procedure Development 5%
Participate in the resolution of operational problems.
General and Functional supervision is received from Clinic Associate Manager/Managed Care
High school diploma or an equivalent.
2-5 years administrative experience in a health care delivery system or the healthcare insurance industry, preferably in a medical setting.
Demonstrated excellent customer service skills and excellent interpersonal communication skills.
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 and work with minimal supervision.
Demonstrated experience using Microsoft Office software (Word, Excel, PowerPoint).
Experience working with Electronic Medical Record (preferably MIChart).
Experience with medical terminology and human anatomy.
Familiarity with ICD-10 coding.
Demonstrated appointment scheduling skills.
Some knowledge of University or Medical Center policies and procedures.
Familiarity with BCN WebDenis/EReferrals and MiChart.
Knowledge of UHS policies and procedures.
Bi-lingual or multi-lingual skills.
Please Note: Relocation will not be offered for this position.
Starting salary may vary depending on qualifications, experience, and education of the selected candidate.
This role may have reporting obligations under Title IX and Clery.
The University of Michigan is an equal opportunity/affirmative action employer.
Internal Number: 181355
About University of Michigan - Ann Arbor
A great university is made so by its faculty and staff, and Michigan is recognized as one of the best universities to work for in the country. The Michigan culture is known for engaging faculty and staff in all facets of the university to create a workplace that is vibrant and stimulating.For two consecutive years, the Chronicle of Higher Education has placed U-M in its "Great Colleges to Work For" survey. In particular, the university earns high marks for strong relations between faculty and administrators, a collaborative system of governance, strong pay and benefits, and a healthy work/life balance.