Lead System Credentialing Specialist SNE - Munson Medical Oncology

• Full-time
• Shift: Day Shift
• Status:
  Full Time

Location:

Remote Role
- Must Reside in Michigan

Schedule:

Full Time Hours
-Monday
- Friday 8 AM - 4:30 PM

More Than Just Care,It’sCommunity

Imagine doing meaningful work in a place where people vacation.

That’slife at Munson Healthcare - northern Michigan’s largest healthcare system, with eight award-winning community hospitals serving over half a million residents across 29 counties.

If you want a career in healthcare and alifestylemost people only dream about – with freshwater lakes, scenic trails, charming downtowns, a vibrant arts scene, and endless outdoor adventures - you might just be Munson Material.

To us, that means teammates who live by our values of excellence,teamness, positivity, creativity,and a commitment to creating exceptional experiences for our patients and each other. Join a team that delivers outstanding care in one of the most beautiful regions in the country.

Invested in You

Grow:Tuition reimbursement, in-person and online development,and access to ourcareer hubto help you advance.

Thrive:Full benefits, paid holidays, generous PTO, employee discounts, and freeindividualretirement counseling.

Be Well:Free wellness platform for you and your family,pluspersonalizedsupport for personal or family challenges.

Be Heard:Share your ideas and help shape the way we work through improvement huddles, employee surveys, and town hall meetings

Location:

This is a remote position
* Must reside in Michigan*

Schedule:

Full Time Hours Weekly
-Monday - Friday 8AM - 4:30PM

• Exercises a high degree of control over confidential medical information.
• Inputs and updates all insurance information inappropriate screens.
• Verifies eligibility of all insurances available online or by phone.
• Identifies primary and secondary insurance. Inputs insurance information in correct COBorder.
• Obtains claim numbers and verifies that claims areestablishedfor Workmen’s Comp and Auto Insurance.
• Identifies the need for pre-authorization information, makes decisions relating to insurance eligibilityutilizingseveral online systems available eduled patients:
  Obtains anddocumentspre-authorization as appropriate for procedure. Emergent patients:obtainspre-authorization guidelines andcommunicatesinformation to Utilization Management.
• Follow up on all verification issues in a timely manner and communicate information to proper departments regarding information obtained.
• Responsible to keep current onbilling requirements from third parties suchas,Blue Cross/Blue Shield, Medicare, Medicaid, and all other health insurance carriers.
• Performs insurance verification, obtains pre- and retro- certification information for all inpatient activity. Communicates appropriate information to the Utilization Management team as required.
• Refers patients to Financial Counselors to obtain financialassistanceand /or payment arrangements when appropriate.
  • 1.5 years of related experience in healthcare
  • Medical experience is preferred
  • Well versed in medical terminology is highly preferred

Key Competencies and Skills

Advanced keyboard, mouse,computer and Microsoft Office skills. Must have knowledge and ability to learn,accessandutilize
10+ of the computer programs listed below within
90 daysof hire.

• Outlook
• Star
• Insurance Verification systems
• Smart Web
• Power Chart
• First Net
• 3M Coding
• Ontracand related tools
• Next Gen
• Cerner

Mustpossessexceptional oral and written communication skills. Ability todemonstrateeffective communication with patients, Dr’sofficesand technicians within hospital departments, and createaccuratedocumentation with information gathered.

Mustbe warm, friendly, and sensitive to the feelings and concerns of others.

Ability todemonstrateeffective communication with…