Utilization Rev Appeals Spec
Job Description
Job Summary
Why Join Michigan Medicine's Hospital Billing Audits & Appeals (HBAA) Department?
The Audit and Appeals Specialist has a strong knowledge of medical appeal and audit practices for both the inpatient and outpatient populations. They are knowledgeable about insurance requirements and medical billing practices. The Appeals Specialist will collaborate with multiple departments to maintain compliance with CMS regulations and third party payer requirements. They appeal based on medical necessity, level of care, administrative and outpatient denials. They manage and respond to Medicare, Medicare Advantage, Varis, Medicaid and other various commercial audits. The Appeals Specialist will communicate and provide education, with information gained from the audits and appeals they manage, to the appropriate department to ensure first time quality.
Perks and Benefits to Look Forward to:
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.
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?
Responsibilities*
Required Qualifications*
Desired Qualifications*
Work Schedule
This is a full-time, 40 hour/week, exempt position. We are open for business between the hours of 5:30AM and 6:00PM Monday-Friday. The typical work schedule would be set within this timeframe.
Work Locations
Work From Home position or Alternate:
KMS Building
3621 S. State Street
Ann Arbor, MI 48108
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 here.
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.
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/AA Statement
The University of Michigan is an equal opportunity/affirmative action employer.
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