Insurance Verifier - Remote Position

About Munson Healthcare

Munson Healthcare is northern Michigan's leading healthcare provider, operating eight distinguished community hospitals and serving more than half a million people across 29 counties. Working here means being part of a team that values excellence, collaboration, positivity, creativity, and delivering outstanding patient experiences. The region offers a unique lifestyle with access to freshwater lakes, scenic trails, vibrant arts, and many outdoor activities.

Job Overview and Responsibilities

• Manage confidential medical information with strict control and prioritize tasks to meet tight deadlines using sound problem-solving skills.
• Enter and update comprehensive insurance data accurately, verifying eligibility through online systems or phone communications.
• Distinguish primary and secondary insurance coverages, ensuring Correct Coordination of Benefits (COB) is recorded.
• Retrieve claim numbers and confirm claims are filed for Workmen's Compensation and auto insurance cases.
• Determine the necessity for pre-authorization, obtain and document this information timely for scheduled procedures, and coordinate urgent cases with Utilization Management.
• Follow up promptly on all insurance verification issues and relay information to relevant departments.
• Maintain up-to-date knowledge of billing guidelines for major insurance providers including Blue Cross/Blue Shield, Medicare, and Medicaid.
• Verify insurance for inpatient care, securing pre- and retroactive certifications, communicating appropriately with Utilization Management.
• Refer patients needing financial aid or payment plans to Financial Counselors.
• Prioritize and problem-solve work activities; keep educational materials updated at the team level.
• Handle various reports, meet quality and productivity standards, and document patient financial responsibilities.

Qualifications and Experience

• Associate degree or minimum of two years equivalent work experience.
• At least 1.5 years of relevant healthcare experience.
• Strong understanding of current third-party payer reimbursement regulations.

Additional Details

• This is a fully remote role.
• Working hours rotate between 7:00 AM to 3:30 PM and 8:00 AM to 4:30 PM shifts with required weekend work every fourth weekend.
• Standard work week consists of 40 hours.
• Munson Healthcare mandates vaccination or confirmed immunity against Measles, Mumps, Rubella, and Varicella, and annual flu vaccination or approved exemptions.

Employee Benefits and Growth

• Access to tuition reimbursement and career advancement opportunities via online and in-person development programs.
• Comprehensive benefits including paid holidays, ample paid time off, employee discounts, and retirement counseling.
• Wellness support with platforms available for employees and families and resources for personal or family challenges.
• Opportunities for employee feedback and participation in organizational improvement through surveys, town halls, and team meetings.