Job SummaryUnder general direction, assists in the provision of the highest service level possible to patients/customers to ensure their satisfaction. Participates in activities with third party payors in order to maximize reimbursement.Essential Functions
Understands and accesses insurance websites. Completes required duties as defined for specific payers to obtain authorization numbers for payment.
Provides clerical support for Utilization Management; sorting faxes and mail, obtaining authorization numbers, completing follow-up on outstanding cases, and delivery of letters associated with outpatient or inpatient status.
Utilizes electronic medical record work queues that support Utilization Management functions.
Answers incoming calls or places outbound calls with appropriate communication skills. Triages all calls to the appropriate person for resolution and action or completes appropriate follow-up.
Problem solves issues that are received via phone, fax or email.
Other duties as assigned.
Qualifications
High School Diploma or G.E.D. completion required. Post high school training and/or academic coursework leading toward associate’s or bachelor’s degree preferred.
Two years of healthcare experience preferred.
Competency and comprehension of basic medical terminology. Well-developed computer skills and/or business related software/application literacy.
Primary LocationSITE - Beaumont Service Center - 26901 Beaumont BlvdDepartment NameUtilization Management - CH EastEmployment TypeFull timeShiftDay (United States of America)Weekly Scheduled Hours40Hours of WorkVariableDays WorkedMonday to FridayWeekend FrequencyN/ACURRENT COREWELL HEALTH TEAM MEMBERS – Please apply through Find Jobs from your Workday team member account. This career site is for Non-Corewell Health team members only. Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief.Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team.You may request assistance in completing the application process by calling 616.486.7447.People are at the heart of everything we do, and the inspiration for our legacy of outstanding outcomes, innovation, strong community partnerships, philanthropy and transparency. Corewell Health is a not-for-profit health system that provides health care and coverage with an exceptional team of 60,000+ dedicated people—including more than 11,500 physicians and advanced practice providers and more than 15,000 nurses providing care and services in 22 hospitals, 300+ outpatient locations and several post-acute facilities—and Priority Health, a provider-sponsored health plan serving more than 1.2 million members. Through experience and collaboration, we are reimagining a better, more equitable model of health and wellness.