Patient Business Associate

at  University of Michigan

JOB SUMMARY

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.

REQUIRED QUALIFICATIONS*

• 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.

DESIRED QUALIFICATIONS*

• 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.

• 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