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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.

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 savingsResponsibilities*

Essential:

Data entry of clinical review information for online authorizations into multiple web sites for multiple payers Maintain accuracy of payer grid by notifying appropriate staff and Revenue Cycle of changes in fax numbers, etc. Obtain authorization for services from third party payers and notify RN Case Manager of issues with authorizations Enter authorization numbers and approval days/dates into the appropriate software system for utilization management and electronic medical records. Fax clinical reviews to payers, maintain confirmations, document completely and accurately activities performed Interact with payers during phone conversations, provide discharge dates and patient status information Respond to email from Billing Department with requests for authorization numbers or patient status Answer departmental phones/messages and distribute to RN Case Managers mindful of coverage assignments. Assist in obtaining authorization for inpatient and observation care by providing payers with clinical information via fax, autoroute, and web-based programs, for example, E-Referral, Navinet, Pnote Demonstrate ability to use multiple computer programs to research patient information Willingly and consistently offer assistance to staff especially when patient census is high Actively participate in learning new technologies Provide notification to out of state insurers when requested by case managers Other duties as assigned

DAILY WORK DUTIES

Insurance Alert Changes from software system for utilization management: notify RN CM if additional clinicals are required For web-based programs, for example, P Notes for Blue Cross PPO and Traditional and E Referral for Blue Cross Network (BCN), input patient data, submit initial review with InterQual criteria subset (1511 work queue) Utilize Accuroute a software fax program effectively Authorizations/Certifications – obtained by phone calls, faxes, payer contact screen Combining Admissions – documenting in MiChart, submit codes for billing Telephone notification of out of state insurers, providing ICD codes (clinical follows) Navinet – Online portal to start process for Aetna, Cigna, BC Complete, Amerihealth, Priority to obtain authorizations and check for updates General faxing DCPA – authorizations pended, discharge information required 223 List in MiChart to complete input of auths/certs Follow up on emails from professional billers by editing patient information in the utilization management software. Distribution of cases on the unassigned worklistRequired Qualifications* High School Diploma or GED. An Associate's degree in social sciences or other related field or an equivalent combination of education and experience is necessary 2 -3 years of experience. Analytical skills are necessary in order to assess urgency and complexity of workflow Proficiency in medical terminology Proficiency in use of computer technology and experience with Microsoft Office software applications Strong interpersonal communication skills, including problem solving and decision making Demonstrated telephone communication skills required Experience in a health care environment Ability to work well with physicians and other health care providers Strong customer service and ability to work in a team environmentDesired Qualifications* Knowledge of UR processes and different levels of care within a hospital Knowledge of the University of Michigan Hospitals and Health Systems computer software systems Knowledge of the University of Michigan Hospitals and Health Systems Policies and ProceduresWork Schedule

Work schedule varies.  Monday through Friday with some weekend and holiday coverage. Hours are 9:00am to 5:30pm

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.

Union Affiliation

This position is included in the bargaining unit represented by the Service Employees International Union - Healthcare Michigan (SEIU), which represents bargaining unit members in all matters with respect to wages, benefits, hours, and other terms and conditions of employment. 

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. 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.