Insurance Verifier

This is a fully remote position, open to applicants in Michigan.

📋 Description

• Enter and update all insurance data in the relevant systems.

• Confirm insurance eligibility through online platforms or phone calls.

• Determine primary and secondary insurance and input information in the correct COB sequence.

• Acquire claim numbers and validate claims for Workers’ Compensation and Auto Insurance.

• Recognize pre-authorization requirements and make insurance eligibility decisions using various online systems.

• Secure and document pre-authorization for scheduled procedures.

• Gather pre-authorization guidelines for emergency patients and relay them to Utilization Management.

• Follow up on verification discrepancies and relay information to the appropriate departments.

• Stay updated on third-party billing regulations, including those for Blue Cross/Blue Shield, Medicare, Medicaid, and other insurers.

• Conduct insurance verification and obtain pre- and retro-certification data for inpatient activities.

• Communicate pertinent information to the Utilization Management team.

• Refer patients to Financial Counselors for financial aid or payment plans when necessary.

• Manage confidential medical records.

⛳️ Requirements

• Must be a resident of Michigan.

• Full-time availability required, Monday through Friday, 8:00 AM to 4:30 PM.

• Associate Degree or equivalent experience required.

• A minimum of 1.5 years of relevant experience in healthcare.

• Medical experience is preferred.

• Strong familiarity with medical terminology is highly preferred.

• Proficient in keyboard, mouse, computer operations, and Microsoft Office applications.

• Capability to learn, access, and utilize over 10 specified computer programs within 90 days of hiring.

• Knowledge of Outlook, Star Insurance Verification systems, Smart Web, PowerChart, FirstNet, 3M Coding, Ontrac, NextGen, and Cerner.

• Outstanding oral and written communication skills.

• Ability to interact effectively with patients, doctors’ offices, hospital technicians, departments, and insurance providers.

• Competence in creating accurate documentation from collected information.

• Ability to perform online insurance verifications through the internet.

• Flexibility to adapt to changes and fulfill ongoing advanced education requirements.

• Must comply with Munson Healthcare vaccination policies for Measles, Mumps, Rubella, and Varicella, or possess lab-confirmed immunity.

• Required to receive a flu vaccine during the hiring year and annually thereafter, unless an approved medical or religious exemption is granted.

🏝️ Benefits

• Tuition reimbursement.

• Opportunities for in-person and online development.

• Access to a career hub.

• Comprehensive benefits package.

• Paid holidays.

• Generous paid time off.

• Employee discounts.

• Complimentary individual retirement counseling.

• Free wellness platform available for you and your family.

• Personalized support for personal or family challenges.