"Patient Business Associate"

The Outpatient Financial Clearance and Authorization team is looking for a full-time Patient Business Associate to provide timely and thorough insurance and financial risk assessment review for scheduled outpatient services.

• Take necessary steps to acquire accurate and complete insurance information to ensure first time quality and improve the patient financial experience at Michigan Medicine
• Evaluate all patient payment sources, verify insurance eligibility, collect insurance benefit information and document insurance referral and authorization requirements for outpatient appointments and surgeries
• Prepare the patient liability estimate using procedure code(s), diagnosis, payer fee schedule and benefit information. Contact and educate patients on out-of-pocket liability for hospital and professional services prior to appointment and collect and post pre-payments when appropriate
• Verify and update patient demographic and insurance information as needed
• Identify and promptly communicate changes in a patients’ insurance coverage to the outpatient clinic as needed
• Refer patients with insurance concerns requiring immediate attention to the Patient Financial Counselor or alternate funding sources when appropriate based on financial assessment
• Clearly and thoroughly document all actions, contacts, outcomes and interventions
• Respond to insurance related questions from Michigan Medicine customers with promptness and thoroughness
• Review, investigate and resolve outpatient hospital accounts being held due to insurance related issues post service and prior to claim submission
• Attend and participate in operational meetings, utilizing LEAN thinking and principles. Develop standard processes and incorporate efficiencies into daily workflow
• Assist and contribute to the overall achievement of the Michigan Medicine and Patient Business Services quality, operational and financial goals and objectives

High school diploma in combination with experience working with health insurance or in a healthcare setting is essential.

Outstanding customer service, written and verbal communication skills are mandatory.

Ability to prioritize and handle multiple tasks, producing high-quality work in a timely, accurate and efficient manner is required.

Proficiency in the use of computers and basic software applications is necessary.

Ability to be flexible and work within a team-focused, participative management framework is required.

• An Associate’s Degree with three years of progressively complex healthcare registration, insurance and billing experience is preferred.
• Understanding and ability to interpret and communicate insurance benefit information is recommended.
• Familiarity with CPT codes and payer fee schedules is desired.
• Knowledge of No Fault Auto, Michigan Assigned Claims, Veteran’s Affairs, third party and government payer rules and regulations is preferred.
• Experience working in the EPIC system is desired.