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.

Responsibilities*

The Outpatient Financial Clearance and Authorization team is looking for a full-time Supervisor responsible for functions related to financial clearance activities that include timely procurement of authorizations and denial management related to scheduled outpatient services. This includes but not limited to:

Supervise the daily operations of staff responsible for performing financial clearance activities for complex cases such as: Insurance verification, benefit eligibility, prior authorization/notification requirements, patient estimate, pre-collections and patient education and redirection.
Coordinate staff workload to ensure authorizations are received timely and secured prior to patient's appointment
Interview, select and orient new employees, setting hours of work and workload assignments in conjunction with the manager.
Ensure staff are adequately trained 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.
Document and evaluate staff productivity. Conduct regular meetings with staff to discuss individual productivity statistics and provide timely feedback.
Perform routine quality reviews and audits to ensure that performance standards are being met.
Prepare detailed analysis reports based on productivity and quality review interpretation and results. Organize and present findings to manager.
Review and evaluate quality assurance (QA) data; implement improvement at the unit level to minimize errors; evaluates key performance indicator (KPI) data; identify opportunities to increase efficiency and implement performance improvement projects.
Monitor and adjust workflow processes and work queues to ensure staff are working efficiently and prioritizing appropriately
Develop, recommend, and coordinate the implementation of new processes 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.
Investigate, distribute, and resolve insurance and billing issues that are related to authorization and financial clearance activity.
Complete root cause analysis on denials and follow up with staff and customers to educate and implement processes to ensure positive outcomes.
Intercede with difficult customers and/or cases requiring in-depth knowledge of the prior authorization and financial clearance workflows.
Attend and/or lead internal and external departmental meetings as needed or requested.
Coordinates special projects related to financial clearance and authorization as assigned.
Oversee the efficient operation and utilization of equipment. Ensure all compliance regulations are being met.
Other duties as assigned that support the success of the outpatient authorization and financial clearance team and workflow processes.

Required Qualifications*

An Associate's degree in Healthcare Administration, Health Information Technology, Business or other healthcare related field, or equivalent amount of years' experience and 5 years of experience within a healthcare setting is necessary.
Knowledge of health insurance, third party payers, 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.

Desired Qualifications*

A Bachelor's 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.

Work Locations

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.

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.

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.