Job Summary

Performs coordination, monitoring, maintenance, updating of the Revenue Cycle's Transplant cases in order to optimize gross and net revenue and ensure compliance with third party payer contracts and billing requirements. Ensures timely review of contract updates guidelines and implements necessary changes affecting the specialty billing team and proposes process improvements. Works closely with the clinical and administrative staff in specialty billing areas to ensure all patient accounts are handled in accordance with approved processes. Position works closely with the staff in various Clinical Departments, Patient Financial Services, Registration, Integrated Payment Posting, Contracting, and Payors. Position ensures timely and accurate billing and collection of all Transplant cases claims/packages in accordance with established policies for both Hospital billings and Professional Billings.

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.

Why Work at Michigan?

Why Join the Revenue Cycle Department, Consolidated Billing Unit TRANPLANT BILLING Team?

If you are a highly motivated individual, if you like to be part of a goal oriented team, if you desire to part of a unit that is interested in what you bring to the table, if you would like to see your well thought out ideas considered and utilized, if you wish to experience a team built on high collaboration, if you would like to be able to use all your billing knowledge to resolve both the hospital and professional receivable together, and part of a team that gets things done, this IS the team for you to demonstrate your superior skills and knowledge.

We are seeking a seasoned Hospital and / or Professional Billing knowledge based individual to join our dedicated team of revenue cycle professionals. We are in search of a highly committed and knowledgeable individual whose primary responsibilities will include accurate claim submissions, active collections, resolving complex insurance / patient inquiries, and reimbursement issues in a highly collaborative environment. This position also plays a vital role in monitoring and analyzing outstanding insurance receivables with responsibility for ensuring optimal reimbursement. This position resolves the complete account Hospital and Professional receivables together.

What Perks and Benefits Can You Look Forward to?

2:1 match on retirement savings
Excellent medical, dental, and vision coverage starting on day one of employment
Generous Paid Time Off (PTO) and paid holidays
Work Remotely / Onsite
Flexible schedule

Responsibilities*

Perform post-transplant billing counseling services to patients including, discussion of benefits, financial concerns. Confirm patient insurance coverage, obtain, verify and update insurance, financial, statistical and demographic information.
Monitor incoming patient accounts ensuring accuracy in billing, collections and payment processing.
Investigate complex reimbursement issues pursuing appropriate actions to include statusing, adjustments, refunds, and transfers or billing third party payers.
Pursue collections of outstanding accounts ensuring not only that appropriate actions and decisions are made on the aged accounts but that all accounts with the patient are resolved.
Initiate adjustments, settlements, write-offs within established guidelines.
Assist Credit Balance team to ensure appropriate refunding transactions connected to multiple payment accounts.
Respond to complex financial questions regarding patient accounts. Answer inquiries and resolve problems for patients, staff and payors including resolutions of disputed billings, liability transfers, and system programming issues.
Review changes made to transplant contracts, provide input to Contracting regarding operational, reimbursement and collection concerns.
Review of all regulatory and third party payer billing requirements to assess their impact on the transplant team activities and ensure such issues are disseminated to the appropriate hospital personnel. Coordinates with Patient Financial Services, HIM/Coding Department's, Transplant Clinic staff, and other internal customers to ensure that the billing is accurate and in compliance with regulatory and/or contractual guidelines.
Assist with development of analytical reporting to streamline data for use by internal and external customers.
Suggest and assist with implementation of reporting and other mechanisms to ensure efficiency and accuracy in the revenue cycle processes.
Assist in the development/revision of team policies and procedures.
Serve as a resource to various internal departments, external payers regarding complex reimbursement issues and related operational issues.
Establish and maintain positive working relationships with department administrators, revenue cycle staff, payors and all other customers.

Required Qualifications*

Current (within last 2 years 2022-2024) knowledge base in Hospital and/or Professional Billing (claims follow up, payer billing rules, bundling rules, etc.)
A minimum of 2 years medical billing experience in Hospital and/or Professional billing with multiple payers
Proficient use computer software applications: Word, Excel, PowerPoint, TEAMS, ZOOM
Proficient and utilizes third party systems for claims tracking, authorization denial and payment review. (i.e., Champs, CSNAP, Availity, etc.)
Demonstrates flexibility and manages change in a way that promotes productive performance.
Strong quantitative, analytical, and organizational skills.
Initiate effective approaches to problem solving.
Possess thorough knowledge of online systems with ability to understand interfaces, data flow, work queue rules and system structure that have implications and impact on the daily work.
Organized, self-starter and detail oriented.
Ability to recognize trends or system problems and take appropriate action to report and resolve.
Strong decision-making skills that affects immediate processing of all revenue cycle functions.
Excellent oral and written communication skills are required. Must exhibit excellent attendance.

Desired Qualifications*

Proficient in EPIC (MiChart)
A minimum of five years medical billing experience in hospital and/or professional billing with multiple payers
Facility coding process and/or reimbursement experience, including familiarity with the functions and compliance concerns related to revenue cycle activities, or equivalents (combined) years of education and experience.
Demonstrated knowledge of CMS regulations, various data elements associated with the UB-04 and HCFA-1500 claim form
Demonstrates leadership qualities by employing integrity, team work, and ethical behavior.

Work Locations

This position is primarily a remote position. However, preparation of "Package Billings" requires onsite activity generally only 1 day per week. On site work is located at 700 KMS Place, 3621 S. State St. Ann Arbor, MI

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.