Michigan Medicine · 2 hours ago
Utilization Management Assistant (Patient Services Intermediate)
Ann Arbor, MI
Part-time
Onsite
Mid Level
3+ years expMichigan Medicine is one of the largest health care complexes in the world, dedicated to improving health through education, patient care, and research. The Utilization Management Assistant will be responsible for data entry of clinical review information, obtaining authorizations from payers, and maintaining communication with the billing department and RN Case Managers.
EducationHealth CareMedical
Responsibilities
Data entry of clinical review information for online authorizations into multiple web sites for multiple payers
Maintain accuracy of payer grid by notifying appropriate staff and Revenue Cycle of changes in fax numbers, etc
Obtain authorization for services from third party payers and notify RN Case Manager of issues with authorizations
Enter authorization numbers and approval days/dates into the appropriate software system for utilization management and electronic medical records
Fax clinical reviews to payers, maintain confirmations, document completely and accurately activities performed
Interact with payers during phone conversations, provide discharge dates and patient status information
Respond to email from Billing Department with requests for authorization numbers or patient status
Answer departmental phones/messages and distribute to RN Case Managers mindful of coverage assignments
Assist in obtaining authorization for inpatient and observation care by providing payers with clinical information via fax, autoroute, and web-based programs, for example, E-Referral, Navinet, Pnote
Demonstrate ability to use multiple computer programs to research patient information
Willingly and consistently offer assistance to staff especially when patient census is high
Actively participate in learning new technologies
Provide notification to out of state insurers when requested by case managers
Other duties as assigned
Scheduling Physician "Peer to Peer" (P2Ps) Review Meetings and documenting outcomes
Insurance Alert Changes from software system for utilization management: notify RN CM if additional clinicals are required
For web-based programs, for example, P Notes for Blue Cross PPO and Traditional and E Referral for Blue Cross Network (BCN), input patient data, submit initial review with InterQual criteria subset (1511 work queue)
Utilize Accuroute a software fax program effectively
Authorizations/Certifications - obtained by phone calls, faxes, payer contact screen
Combining Admissions - documenting in MiChart, submit codes for billing
Telephone notification of out of state insurers, providing ICD codes (clinical follows)
Navinet - Online portal to start process for Aetna, Cigna, BC Complete, Amerihealth, Priority to obtain authorizations and check for updates
General faxing
DCPA - authorizations pended, discharge information required
223 List in MiChart to complete input of auths/certs
Follow up on emails from professional billers by editing patient information in the utilization management software
Distribution of cases on the unassigned worklist
Qualification
Required
High School Diploma or GED
Minimum 3 years of experience
Analytical skills are necessary in order to assess urgency and complexity of workflow
Proficiency in medical terminology
Proficiency in use of computer technology and experience with Microsoft Office software applications
Strong interpersonal communication skills, including problem solving and decision making
Demonstrated telephone communication skills required
Experience in a health care environment
Ability to work well with physicians and other health care providers
Strong customer service and ability to work in a team environment
Preferred
Knowledge of UR processes and different levels of care within a hospital
Knowledge of the University of Michigan Hospitals and Health Systems computer software systems
Knowledge of the University of Michigan Hospitals and Health Systems Policies and Procedures
Benefits
Excellent medical, dental and vision coverage effective on your very first day
2:1 Match on retirement savings
Company
Michigan Medicine
Michigan Medicine is a health care system and academic medical center that provides medical education and more. It is a sub-organization of University of Maichigan.
10001+ employees
Funding
Current Stage
Late StageLeadership Team
Heather Ascani
Director, Business Operations - Applied Systems Biology Core
Jack Kufahl
Chief Information Security Officer
Recent News
2025-12-11
Company data provided by crunchbase