This position is REMOTE
8 hour shifts between 7:30am and 6:00pm
GENERAL SUMMARY:
The support specialist is a support role crucial to the centralized Utilization Review team for time sensitive authorization tracking and resolution process.
Responsible for obtaining and tracking approvals, denials, and additional information requests received from third party payers within the EMR.
PRINCIPLE DUTIES AND RESPONSIBILITIES:
Acts as a subject matter expert in insurance authorization requirements, timeframes, and various revenue cycle related requirements.
Submits all clinical information required by payers.
Responds to payer requests, inquiries, and/or escalates issues to leadership.
Processes, familiarizes, and completes communication forms required by payers.
Works directly with coordinators regarding clinical issues for resolution.
Processes all incoming communication from payers via fax, voicemail, email and mail, appropriately routes information to assigned team members.
Update and load case information to payers as needed.
Maintain a current knowledge of Utilization Management through interaction with staff and payor portal representatives.
Identify process improvement strategies.
Promotes individual professional growth and development by meeting requirements for mandatory continuing education and supports department goals which contribute to success of the organization.
Perform other duties as requested.
EDUCATION/EXPERIENCE REQUIRED:
High School Diploma/G.E.D.
Working knowledge of computers and software systems
Communication skills, verbal and written, and interpersonal skills necessary to
effectively achieve department outcomes.
Additional Information
Organization: Corporate Services
Department: Central Utilization Mgt
Shift: Day Job
Union Code: Not Applicable
Additional Details
This posting represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of all tasks and functions. It should be understood, therefore, that incumbents may be asked to perform job-related duties beyond those explicitly described above.
Overview
Partnering with nearly 2 million people on their health journey, Henry Ford Health provides a full continuum of services at 250 care locations throughout southeast and south central Michigan. With 33,000 valued team members, Henry Ford is also among Michigan's largest and most diverse employers. Our superior care and discoveries are powered by nearly 6,000 physicians, researchers and advanced practice providers. Learn more athenryford.com.
Benefits
Whether it's offering a new medical option, helping you make healthier lifestyle choices or making the employee enrollment selection experience easier, it's all about choice. Henry Ford Health has a new approach for its employee benefits program - My Choice Rewards. My Choice Rewards is a program as diverse as the people it serves. There are dozens of options for all of our employees including compensation, benefits, work/life balance and learning - options that enhance your career and add value to your personal life. As an employee you are provided access to Retirement Programs, an Employee Assistance Program (Henry Ford Enhanced), Tuition Reimbursement, Paid Time Off, Employee Health and Wellness, and a whole host of other benefits and services. Employee's classified as contingent status are not eligible for benefits.
Equal Employment Opportunity/Affirmative Action Employer
Equal Employment Opportunity / Affirmative Action Employer Henry Ford Health is committed to the hiring, advancement and fair treatment of all individuals without regard to race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height, weight, marital status, family status, gender identity, sexual orientation, and genetic information, or any other protected status in accordance with applicable federal and state laws.