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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.

Insurance Verifier - Remote Position