Customer Service Representative Intermediate

Michigan Medicine; Ann Arbor (MI); Hybrid; USD 42,000 - 54,000; Full time

Benefits offered by this job

Excellent medical, dental and vision

2:1 retirement match

Job summary

Michigan Medicine is seeking a detail-oriented Scheduling and Referral Specialist for Home Care Services. You will provide exceptional customer service, process referrals, verify insurance, and coordinate clinician schedules for MVN patients.

The role requires teamwork and effective communication in a hybrid work environment. Responsibilities include handling referrals, obtaining prior authorizations, data entry, and collaborating with clinics, physicians, and care managers to ensure timely

Qualifications

• Requires high school diploma or equivalent.
• 2–5 years of comparable office experience preferred.
• Excellent customer service and strong interpersonal skills required.
• Effective written and verbal communication and active listening.
• Proficient with Microsoft Office and related software.

Responsibilities

• Provide exemplary customer service to internal and external customers.
• Process referrals and authorize home care services.
• Verify insurance benefits and copays; obtain prior authorization.
• Enter data accurately and maintain scheduling for MVN patients.
• Coordinate clinician schedules and communicate with patients and staff.
• Act as liaison with clinics, physicians and Care Managers to obtain information.
• Assist in onboarding and orientation for new staff.
• Support daily workflow and area metrics monitoring.
• Collaborate with management to ensure timely scheduling and billing.

Skills

Customer service

Interpersonal skills

Communication skills

Active listening (written & verbal)

Proficient with MS Office

Education

High school diploma or equivalent

Associate's or Bachelor's degree in Business/Health Admin

Tools

EPIC home health software

MiChart

Job description

Mission Statement

Michigan Medicine improves the health of patients, populations and communities through excellence in education, patient care, community service, research and technology development, and through leadership activities in Michigan, nationally and internationally. Our mission is guided by our Strategic Principles and has three critical components; patient care, education and research that together enhance our contribution to society.

Responsibilities

Basic Function And Responsibilities

This position is responsible for providing exemplary customer service to internal and external customers for routine and non-routine business. Possesses and applies a broad knowledge of principles, practices, and procedures particular to Michigan Visiting Nurses.

Applies originality and ingenuity to resolving complex issues. Responsibilities include but are not limited to process and evaluate referrals for accuracy and completeness; schedule field staff assignments for a designated patient population; verify insurance benefits and copays; obtaining prior authorization for clinical services; identifying and informing Supervisor (Charge Nurse, Clinical Care Coordinator, etc.) of referral issues, problems and trends. Collaborates with referral sources, including clinics, physicians, and hospital Care Managers, to obtain necessary information regarding referrals. Supports operational process by coordinating workflow.

Applies advanced skills to the position, and adapts procedures, processes, and techniques to meet the more complex requirements of the position. Resolves most questions and problems and refers only the most complex issues to higher levels.

Essential Duties And Responsibilities

• Provides excellent customer service and pro-actively problem solves to ensure efficient and accurate processing of referrals and authorizations to ensure optimum operations for all department functions.
• Monitors and processes all referrals for MVN home care services
• Verifies home care insurance benefits and eligibility, including copay and deductible amounts, to initiate service in a timely manner.
• Obtains prior authorization and reauthorization for all services provided.
• Efficiently performs timely and accurate data entry of referral and insurance information.
• Coordinates the scheduling for all MVN patients and assigns clinician schedules using established guidelines. Provides timely communication with patients and staff regarding scheduling.
• Acts as liaison for the department by promoting collaborative communication with referral sources, patients/families, the public and team members to develop, support and maintain positive relationships.
• Refers clinical questions and issues with home care referrals and physician orders to the Supervisor, Clinical Care Coordinator, or Charge Nurse.
• Responsible for the coordination of daily workflow.
• Updates work schedules to address acute needs or changes in staffing resources.
• Participates in orientation, training, and onboarding for new staff.
• Participates with the leadership team to ensure effective operations.
• Serves as the point of contact for telephone triage of patient referral and scheduling inquiries.
• Leads and participates in area huddles.
• Images documents into the media tab of MiChart.
• Tracks and ensures necessary documentation to fulfill prior authorization and re-authorization requirements for billing and collection purposes.
• Monitors and reviews work queues independently on a daily basis for resolution of issue to ensure timely initiation of scheduling, discharge and billing processes.
• Independently resolves problems interdepartmentally and externally, including clinicians, billing, MiChart team, etc.
• Assists patients navigating them through the complex logistics of the health system.
• Proficiently use department technology to execute assigned tasks.
• Participates in regular evaluation of area metrics (i.e., timely initiation of care).
• Collaborates with management and staff to distribute immediate notification of a supply recall.
• Manages all supply ordering for patients and staff, assuring full stock is maintained and available for field clinicians. Manages supply accounts through various vendors.
• Contacts patients to audit the receipt of supplies and satisfaction with service.
• Collaborates with the Wound Care Coordinator and supervisors regarding coordination of care and delivery of cost-effective product selection.
• Provides cross-coverage for all MVN areas (OB/Peds, Adult Certified, Rehabilitation). May specialize in certain patient population referrals, scheduling, and coordination.
• Orients new staff to scheduling guidelines and supply coordination.
• Proactively participates in continuous quality improvement and review of existing processes. Makes recommendations for more efficient alternatives.
• Contributes to a positive work environment.
• Patient and Family Centered Care:
  • Actively engages the patient and family, as applicable, by exhibiting respect and dignity, sharing information in a timely and unbiased manner, and welcoming and encouraging participation to achieve shared decision making.
  • Collaborates with other members of the team, including the patient and family, to achieve the ideal patient care experience.
• MVN weekend coverage, as assigned

Other Related Duties

• Complies with all University of Michigan and departmental standards and expectations.
• Supports the department's commitment to continuous improvement activities and principles through positive and respectful contributions in all problem-solving and change processes at Home Care Services.
• Handles special assignments and provides a variety of clinical/clerical support activities, and performs other duties as assigned by the supervisor.

Required Qualifications

• High School diploma or equivalent
• 2-5 years of comparable office experience
• Excellent customer service
• Exceptional interpersonal skills and the ability to work well within a team setting
• Effective communication skills
• Demonstrated active listening, written, and verbal skills
• Knowledge of medical terminology
• Able to prioritize and complete work in a self-directed manner
• Proficient computer skills, including Microsoft Office products and other software applications
• Ability to work independently and efficiently
• Ability to travel from point A to point B throughout the workday as assigned.
• Ability to work on-site or alternate location as needed.

Desired Qualifications

• Previous experience in a home health setting
• Associate's or Bachelor's degree in Business, Health Administration or health-related field
• Working knowledge of a variety of health insurance eligibility, authorizatio,n and verification requirements
• Experience in EPIC home health software systems
• Proficiency in medical terminology

Why Join Michigan Medicine?

Michigan Medicine is one of the largest health care complexes in the world and has been the site of many groundbreaking medical and technological advancements since the opening of the U-M Medical School in 1850. Michigan Medicine is comprised of over 30,000 employees and our vision is to attract, inspire, and develop outstanding people in medicine, sciences, and healthcare to become one of the world?s most distinguished academic health systems. In some way, great or small, every person here helps to advance this world-class institution. Work at Michigan Medicine and become a victor for the greater good.

What Benefits can you Look Forward to?

• Excellent medical, dental and vision coverage effective on your very first day
• 2:1 Match on retirement savings

Modes of Work

Positions that are eligible for hybrid or mobile/remote work mode are at the discretion of the hiring department. Work agreements are reviewed annually at a minimum and are subject to change at any time, and for any reason, throughout the course of employment. Learn more about the work modes.

Additional Information

Physical Requirements

The employee will be able to perform the assigned duties and responsibilities with or without reasonable accommodations: ability to work in a sedentary position for long periods of time, ability to communicate/ exchange information, fine motor coordination/dexterity necessary for keyboarding or typing, and may require reaching, bending, twisting, stooping, moving about, lifting of up to 10 pounds, etc., with or without the use of assistive/adaptive devices.

Occupational Hazard Information

Staff members may have routine exposure to all chemical inventory, inclusive of hazardous materials, housed at all work sites for Home Care Services, including but not limited to: the office, hospital, clinics, vehicles and warehouse. Chemical inventory reference materials are available to all staff in the form of hard copy and on-line Material Safety Data Sheets.

Staff may carry out assignments in patient's homes, hospitals, clinics and HCS offices. Staff may drive personal or University owned vehicle and walk on uneven surfaces to these various work site locations in all weather conditions on a regular basis.

This description is intended to indicate the kinds of tasks and levels of work and/or difficulty that will be required of positions given this title and shall not be construed as declaring what the specific duties and responsibility of any particular position shall be. It is not intended to limit or in any way modify the right of any supervisor to assign, direct and control the work of employees under their supervision.

Background Screening

Michigan Medicine conducts background screening and pre-employment drug testing on job candidates upon acceptance of a contingent job offer and may use a third-party administrator to conduct background screenings. Background screenings are performed in compliance with the Fair Credit Report Act. Pre-employment drug testing applies to all selected candidates, including new or additional faculty and staff appointments, as well as transfers from other U-M campuses.

In addition to the screenings indicated above under Michigan law, a criminal history check including fingerprinting is required as a condition of transfer or employment for this position.

Application Deadline

Job openings are posted for a minimum of seven calendar days. The review and selection process may begin as early as the eighth day after posting. This opening may be removed from posting boards and filled anytime after the minimum posting period has ended.

U-M EEO Statement

The University of Michigan is an Equal Opportunity Employer. We are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants, including protected veterans and individuals with disabilities.