Insurance Verifier - Munson Medical Oncology *MUST RESIDE IN MICHIGAN*

Schedule

Remote position; must reside in Michigan. Full-time, Monday–Friday, 8:00 AM – 4:30 PM.

About the role

Munson Healthcare is northern Michigan’s largest healthcare system, with eight award-winning community hospitals serving over half a million residents across 29 counties. The organization offers a career in healthcare with a lifestyle featuring freshwater lakes, scenic trails, charming downtowns, a vibrant arts scene, and endless outdoor adventures. Teammates live by values of excellence, teamness, positivity, creativity, and a commitment to creating exceptional experiences for patients and each other.

Benefits

• Grow: Tuition reimbursement, in-person and online development, and access to career hub for advancement.
• Thrive: Full benefits, paid holidays, generous PTO, employee discounts, and free individual retirement counseling.
• Be Well: Free wellness platform for you and your family, plus personalized support for personal or family challenges.
• Be Heard: Share ideas and help shape the way we work through improvement huddles, employee surveys, and town hall meetings.

Responsibilities

• Exercises a high degree of control over confidential medical information.
• Inputs and updates all insurance information in appropriate screens.
• Verifies eligibility of all insurances available online or by phone.
• Identifies primary and secondary insurance.
• Inputs insurance information in correct COB order.
• Obtains claim numbers and verifies that claims are established for Workers’ Comp and Auto Insurance.
• Identifies the need for pre-authorization information, makes decisions relating to insurance eligibility utilizing several online systems available at MMC.
• For scheduled patients: obtains and documents pre-authorization as appropriate for procedure.
• For emergent patients: obtains pre-authorization guidelines and communicates information to Utilization Management.
• Follows up on all verification issues in a timely manner and communicates information to proper departments regarding information obtained.
• Keeps current on billing requirements from third parties such as Blue Cross/Blue Shield, Medicare, Medicaid, and all other health insurance carriers.
• Performs insurance verification, obtains pre- and retro-certification information for all inpatient activity.
• Communicates appropriate information to the Utilization Management team as required.
• Refers patients to Financial Counselors to obtain financial assistance and/or payment arrangements when appropriate.

Qualifications

• Associate degree or equivalent experience.
• 1.5 years of related experience in healthcare and third-party insurance required.
• Medical experience preferred.
• Well-versed in medical terminology highly preferred.
• Munson Healthcare requires all employees to be vaccinated or have lab-confirmed immunity for Measles, Mumps, Rubella, and Varicella.
• All employees must receive a flu