GENERAL SUMMARY

• Department: Primary Care

• Schedule: 8-hour day shift, Monday-Friday

• Location: South Lyon, MI

  Determines and verifies insurance coverage and coordination of benefits from all sources for assigned area. Ensures proper adequate and timely billing to ensure prompt payment.

  · Confirms insurance coverage. Determines necessity for pre-authorization and obtains authorization for scheduled procedures.

  · Determines financial responsibility for services to be provided. Notifies patients and/or practitioners of any services requested and/or referred that are not authorized by insurance.

  · Communicates with patients and practitioners regarding financial responsibility and insurance coverage issues.

  · Maintains detailed documentation in the patient account record of all billing activities. Maintains documentation of claims processed as part of the daily claims reconciliation process.

  · Prepares and completes claims for commercial insurance companies, third party organizations and/or government or self payers.

  · Researches, analyzes and reconciles Medicare/Medicaid billing and reimbursement practices.

  · Maintains detailed documentation in the patient account record of all billing activities.

  · Maintains documentation of claims processed as part of the daily claims reconciliation process.

  · Consults with appropriate parties to resolve unbilled claims. Reviews recent accounts for proper billing practices and reimbursement.

  EDUCATION/EXPERIENCE REQUIRED

  · High School diploma equivalency OR 1 year of applicable cumulative job specific experience required. - Note: Required professional licensure/certification can be used in lieu of education or experience, if applicable

Additional Information

• Organization: Henry Ford Ascension Medical Group MI

• Department: PMHC S Lyon

• 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

Henry Ford Health partners with millions of people on their health journey, across Michigan and around the world. We offer a full continuum of services – from primary and preventative care to complex and specialty care, health insurance, a full suite of home health offerings, virtual care, pharmacy, eye care and other health care retail. With former Ascension southeast Michigan and Flint region locations now part of our team, Henry Ford’s care is available in 13 hospitals and hundreds of ambulatory care locations. Based in Detroit, Henry Ford is one of the nation’s most respected academic medical centers and is leading the Future of Health: Detroit, a $3 billion investment anchored by a reimagined Henry Ford academic healthcare campus. Learn more at henryford.com/careers .

Benefits

The health and overall well-being of our team members is our priority. That’s why we offer support in the various components of our team’s well-being: physical, emotional, social, financial and spiritual. Our Total Rewards program includes competitive health plan options, with three consumer-driven health plans (CDHPs), a PPO plan and an HMO plan. Our team members enjoy a number of additional benefits, ranging from dental and eye care coverage to tuition assistance, family forming benefits, discounts to dozens of businesses and more. Employees 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.