Job Information
University of Michigan Sr Bill Clk/Pat Acct Rep Hlth in Ann Arbor, Michigan
Sr Bill Clk/Pat Acct Rep Hlth
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Job Summary
The Infusion Core Business Team is a Michigan Medicine Ambulatory Care Team dedicated to providing a high quality & comprehensive Financial Clearance for all Adult/Pediatric Cancer & Non-Cancer Infusion Services. The Infusion Core Business Team is also dedicated to handle complex scheduling for all Adult/Pediatric Non-Cancer infusion services. We are actively seeking a compassionate, enthusiastic, and patient-focused individual who will share in the goal of crafting the ideal experience for our patients, families and employees.
Responsibilities*
Review patient benefit level to determine cost share out of pocket expense for upcoming infusions services.
Obtain necessary authorizations or pre-determinations for all infusion services.
Collaborating with Patient Financial Counseling, communicate with patients their cost share expectations and collect pre-payment for services, including alternative payment options. Also providing counseling for patients without insurance coverage on ACA enrollment, Medicaid and M-Support screening.
Verify patient demographic and insurance information, collaborating with Registration for changes, when needed.
Provide Insurance Verification for coverage changes.
Notify clinic staff of patient out of pocket cost for front end collection efforts.
Monitor, interpret and advise management regarding changes to third-party payer system discrepancies, activities and trends.
Contact appropriate third-party representatives for information and assistance with determining benefit level when online resources are not available.
Resolve complex insurance issues, resolve problems with payers prior to service.
Obtain authorization and schedule delivery of medication required to come from a Non- Michigan Medicine Specialty Pharmacy. Including ordering and follow up to ensure drug has arrived prior to service.
Obtain prescription authorizations including pharmacies outside UM Health System
Review infusion documentation, ensuring encounters are closed. Responsible for 100% infusion work queue review.
Review and complete accounts that populate to Billing, High dollar, authorization, denial andscheduling WQ's.
Follow up with infusion nurses and ensure correct billing documentation.
Reconcile all charges, reviewing deletions and WQ issues.
Make appropriate PB/HB charge corrections as needed.
Diagnosis review (ICD-10) for all infusions, including but not limited to CMS, Local Coverage Determination, National Comprehensive Cancer Network Compendium, contact providers for non-covered diagnosis and discuss options, including contacting payer for Medical Director review.
Review claims denials, including requesting medical review. Contact providers and/or PharmD as needed for additional medical documentation.
Review physician extender services for shared, directed and independent visits. Provide reports to Medical Director.
Assist in training new employees.
Work with colleagues to cross-cover when appropriate.
Attend applicable training initiatives which include but are not limited to registration sessions, third party seminars, and in-house training.
Incorporate and practice Lean principles into daily work.
Function as a collaborative and contributing team member.
Demonstrate outstanding customer service skills.
Required Qualifications*
High school diploma or equivalent combination of education and experience.
At least two years of progressively complex billing & third-party payer experience.
Proficiency in use of computers and software, including Microsoft Office products.
Demonstrated excellent verbal and written interpersonal skills.
Demonstrated ability to multitask and produce high-quality work in a timely, accurate and efficient manner.
Demonstrated experience efficiently, professionally and handling patient confidentiality.
Demonstrated outstanding customer service skills.
Demonstrated excellent attendance record.
Demonstrated ability to work independently.
Desired Qualifications*
Knowledge of University of Michigan and UMHS policies, procedures and as well as regulatory requirements.
Experience with UMHS systems including MiChart, Outlook, Webdenis, as well as other payer websites.
Progressive billing experience within 5 years.
Experience with authorizations and diagnosis coding.
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 thework modes (https://hr.umich.edu/working-u-m/my-employment/ways-we-work-resource-center/ways-we-work-implementation-group/modes-work) .
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 anytime after the minimum posting period has ended.
U-M EEO/AA Statement
The University of Michigan is an equal opportunity/affirmative action employer.
Job Detail
Job Opening ID
260512
Working Title
Sr Bill Clk/Pat Acct Rep Hlth
Job Title
Sr Bill Clk/Pat Acct Rep Hlth
Work Location
Michigan Medicine - Ann Arbor
Ann Arbor, MI
Modes of Work
Hybrid
Full/Part Time
Full-Time
Regular/Temporary
Regular
FLSA Status
Nonexempt
Organizational Group
Um Hospital
Department
MM Infusion Core
Posting Begin/End Date
2/21/2025 - 2/28/2025
Career Interest
Finance
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