• Insurance Appeals Coordinator

    Munson Healthcare (Traverse City, MI)


    ENTRY REQUIREMENTS

    • Associate’s degree in business or healthcare related field OR at least five (5) years’ experience in a revenue cycle role (billing, registration, insurance verification, referral coordinator, etc)

    • Ability to work independently and problem solve with minimal supervision.

    • Proficient in Microsoft products including Excel, Word, Outlook, Teams, and SharePoint

    • Experience navigating electronic medical records and revenue cycle programs. Cerner, STAR, and Revenue Cycle experience preferred,

    • Proven organizational skills and can work within strict time frames.

    • Effective in written and verbal communication skills.

    ORGANIZATIONAL RELATIONSHIP

    • Report to the Manager of Utilization Management and works closely with the Utilization Management and Appeals team

    • Interacts independently with all Munson Health Care departments.

    POPULATIONS SERVED COMPETENCIES, INCLUDING AGE OF PATIENTS SERVED

    No direct clinical contact with patients

    SPECIFIC DUTIES

    1. Supports the Mission, Vision and Values of Munson Healthcare

    2. Embraces and supports the Performance Improvement philosophy of Munson Healthcare.

    3. Promotes personal and patient safety.

    4. Has basic understanding of Relationship-Based Care (RBC) principles, meets expectations outlined in Commitment To My Co-workers, and supports RBC unit action plans.

    5. Always uses effective customer service/interpersonal skills

    6. Monitors and sorts incoming communication to the Utilization Management and Appeals department, including faxes, emails, physical mail, and phone calls. Maintains voicemail system and responds to or forwards messages promptly.

    7. Supports and understands the authorization process from submission to final determination and notates any actions taken in the appropriate programs.

    8. Able to coordinate data/responses from all departments involved in the authorization process.

    9. May assist the Utilization Management team with notifying payers of observation or inpatient admissions as appropriate and initiating the authorization process.

    10. Identifies and facilitates appeal responses, gathers clinical packets for appeals, and follows up on appeals submissions with proper documentation of such activities.

    11. Maintains payer communication sheet with the most up-to-date contact information.

    12. Performs all other duties as assigned.