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.
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.
The Centralized Outpatient Authorization team is looking for a full-time Supervisor to supervise functions related to financial clearance activities for scheduled outpatient services. This includes timely procurement of authorizations, benefit collection, estimates, patient liability education, pre-collections and authorization denial management. Responsibilities include but are not limited to the following:
Supervise the daily operations of staff responsible for performing financial clearance activities such as insurance verification, benefit eligibility, prior authorization/insurance notification requirements, patient estimates, pre-collections and patient education and redirection.
Monitor and coordinate staff workload to ensure authorizations are received timely and secured prior to the patient's appointment.
Interview, select and orient new employees, setting hours of work and workload assignments.
Ensure staff are adequately trained to perform their duties and make hiring, disciplinary, and termination recommendations.
Approve requests for time off based on workplace operations; create and maintain schedules; verify accuracy of timesheets for payroll.
Conduct regular 1:1 meetings with staff to discuss individual quality and productivity statistics, no authorization write-off data and provide timely feedback.
Perform routine quality reviews and audits on escalated and denied cases to ensure that performance standards are being met.
- Review and evaluate quality assurance (QA) and productivity data; recommend and implement improvement at the unit level to minimize errors and enhance performance.
Complete root cause analysis on unsecured financial clearance patients, pre-service denials and follow up with staff and customers to educate and recommend processes to ensure positive outcomes.
Intercede with difficult customers and/or cases requiring in-depth knowledge of the prior authorization and financial clearance workflows.
- Investigate, distribute, and resolve insurance and billing issues related to financial clearance and authorization activity
Investigate and recommend technical enhancements and automation opportunities to maximize resources and eliminate waste.
- Evaluate key performance indicator (KPI) data; identify opportunities to increase efficiency and implement performance improvement projects in collaboration with staff and manager.
Develop and maintain unit policies and procedures specific to the job roles.
Monitor, optimize and adjust workflow processes and work queues to ensure staff are working efficiently and prioritizing appropriately.
Monitor payer changes, assess relevancy to financial clearance and prior authorizations and communicate updates to staff effectively and timely.
Attends and participates in Pre-Service Policy & Procedure meetings.
Develop, recommend, and coordinate the implementation of new processes and workflow through the application of LEAN methodology.
Review and track staff ideas for process improvement. Assist in reducing or eliminating barriers that impede staff empowerment, performance, and efficiency.
Conducts annual performance evaluations.
Attend and/or lead internal and external departmental meetings as needed or requested.
Coordinate special projects related to financial clearance, estimates and authorizations as assigned.
Partner with other departments to identify operational opportunities and address gaps.
Other duties as assigned that support the success of the outpatient authorization and financial clearance team and workflow processes.
- An Associates degree in Healthcare Administration, Health Information Technology, Business or other healthcare related field, or equivalent amount of education and 5 years of experience within a healthcare administrative or clinical setting is necessary.
- Knowledge of health insurance coverage and benefits, third party payers, prior authorizations requirements, government regulations and ICD-10 and CPT coding are required.
- Strong written, verbal, and interpersonal communication skills, problem solving, decision making, and negotiation skills are necessary.
- Excellent computer application skills are required.
- Strong dedication to customer service, ability to be flexible and work within a team-focused, participative management framework is required.
- A Bachelors degree in a healthcare or business-related field and prior experience working with health insurances, Prior Authorization, Financial Clearance, or Coding is preferred.
- A CPC certification is strongly desired.
- Previous supervisory and/or project management experience is preferred.
- Understanding and ability to interpret medical terminology and insurance benefit information is preferred.
- Considerable knowledge of university policies, procedures and regulations is desired.
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
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.
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. Staff will be expected to effectively communicate and resolve most computing issues directly with computing support resources.
Supervision Received: This position reports directly to the Manager
Supervision Exercised: Authorization Coordinator Intermediate staff
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.
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.
The University of Michigan is an Equal Opportunity Employer. We are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants, including protected veterans and individuals with disabilities.
