Insurance Verifier - REMOTE

More Than Just Care, It’s Community  

Imagine doing meaningful work in a place where people vacation. That’s life 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 a lifestyle most 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 our career hub to help you advance. 

• Thrive: Full benefits, paid holidays, generous PTO, employee discounts, and free individual retirement counseling.  

• Be Well: Free wellness platform for you and your family, plus personalized support 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  

A Day in the Life

• Exercises a high degree of control over confidential medical information. Able to establish priorities and meet tight deadlines with strong problem-solving ability.
• Inputs and updates all insurance information in appropriate screens. Verifies eligibility of all insurances available online or by phone. 
• Identifies primary and secondary insurance. Inputs insurance information in correct COB order. 
• Obtains claim numbers and verifies that claims are established for Workmen's Comp and Auto Insurance. 
• Identifies the need for pre-authorization information, makes decisions relating to insurance eligibility utilizing several online systems available at MMC. Scheduled patients: Obtains and documents pre-authorization as appropriate for procedure. Emergent patients: obtains pre-authorization guidelines and communicates information 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 on billing requirements from third parties such as 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 financial assistance and/or payment arrangements when appropriate.
• Interprets and initiates problem solving, prioritizes work activity. 
• Keeps educational information, manuals and guides at team level updated and current. Works various reports. Meets productivity and quality standards. Identifies and documents patient financial liability. 

What's Required

• Associate's degree or 2 years' equivalent experience.
• 1.5 years of related experience in healthcare. 
• Knowledge of current third-party payer reimbursement rules required. 

Are you Munson Material? Apply today! 

Fully remote!

Schedule: Rotates between 7-3:30pm and 8-4:30 pm. requires weekend work every 4th weekend.

40 hours/week

Munson Healthcare requires all employees be vaccinated or have lab confirmed immunity for Measles, Mumps, Rubella and Varicella. MHC also requires all employees to receive a flu vaccine during the flu season in the year that they are hired and annually thereafter, or receive an approved medical or religious exemption.