Customer Service Representative Intermediate

Customer Service Representative Intermediate

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.

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.

Excellent medical, dental, and vision coverage effective on your very first day

2:1 Match on retirement savings

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, authorization, and verification requirements

Experience in EPIC home health software systems

Proficiency in medical terminology