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Backend Insurance Verification Jobs in Michigan (NOW HIRING)

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iOS Developer Intern

Detroit, MI

$27.50 - $35/hr

... backend developers, QA, UI/UX, and product owners Integrate REST APIs and third-party services ... and services, banking, insurance and public administration sectors in the definition and ...

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Android Developer Intern

Detroit, MI

$27.50 - $35/hr

... backend developers, QA, UI/UX, and product owners Integrate APIs and third-party libraries ... and services, banking, insurance and public administration sectors in the definition and ...

Reply

iOS Developer Intern

Detroit, MI · On-site

$27.50 - $35/hr

... backend developers, QA, UI/UX, and product owners Integrate REST APIs and third-party services ... and services, banking, insurance and public administration sectors in the definition and ...

Reply

Android Developer Intern

Detroit, MI

$27.50 - $35/hr

... backend developers, QA, UI/UX, and product owners Integrate APIs and third-party libraries ... and services, banking, insurance and public administration sectors in the definition and ...

Reply

iOS Developer Intern

Detroit, MI

$27.50 - $35/hr

... backend developers, QA, UI/UX, and product owners Integrate REST APIs and third-party services ... and services, banking, insurance and public administration sectors in the definition and ...

Reply

Android Developer Intern

Detroit, MI · On-site

$27.50 - $35/hr

... backend developers, QA, UI/UX, and product owners Integrate APIs and third-party libraries ... and services, banking, insurance and public administration sectors in the definition and ...

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Backend Insurance Verification information

What is the difference between Backend Insurance Verification vs Front Desk Insurance Verification?

AspectBackend Insurance VerificationFront Desk Insurance Verification
Primary ResponsibilitiesProcessing insurance claims, verifying coverage electronically, and handling billing issuesChecking insurance information at patient check-in, collecting documents, and initial verification
Work EnvironmentOffice-based, often in billing or administrative departmentsFront desk, reception area, patient check-in stations
Required CredentialsKnowledge of insurance policies, billing software, and healthcare regulationsBasic insurance knowledge, customer service skills, and administrative training
Common UsageUsed in billing departments for detailed claim processingUsed at the point of patient intake for initial verification

Backend Insurance Verification involves processing insurance claims and verifying coverage electronically within billing departments, while Front Desk Insurance Verification focuses on initial patient insurance checks at the front desk. Both roles require insurance knowledge but differ in responsibilities and work environment.

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Backend Insurance Verification jobs near you
Central Authorization Specialist /Full Time/ Remote-Michigan Residents

Central Authorization Specialist /Full Time/ Remote-Michigan Residents

Corporate Services

Detroit, MI • Remote

$17.75 - $23.75/hr

Other

Posted 21 days ago

Job description

The purpose of the Central Authorization Specialist position is to centrally facilitate the successful procuring of insurance authorizations for ordered procedures and post-operative care. This will be done through quality validations of obtained authorizations as well as continuous education and opportunity feedback to a multi-disciplinary team with the underlying objective of managing the cost of care and providing timely and accurate information to payors'. The Central Authorization Specialist helps drive change by identifying areas where performance improvement is needed (e.g., day to day workflow, education, process improvements, patient satisfaction). The Central Authorization Specialist is accountable for a designated caseload and plans effectively in order to meet demands and support resources procuring authorizations. Under general supervision and in accordance with established policies and procedures the specific functions within this role include: Subject matter expertise of precertification and payor authorization processes. Ensure successful authorizations are procured by ordering physician offices through validation of work effort and education of procuring staff. Ensure feedback relevant to successful authorization procurement is obtained from back end coding, billing and denial management resources and distributed to ordering physicians and authorization procurement staff to promote continuous improvement. Application of process improvement methodologies. The responsibilities includes acting as a centralized resource for assigned specialty across all sites of practice to ensure standardized and consistent procurement of authorizations. EDUCATION/EXPERIENCE REQUIRED: High School or 3 - 5 years related experience and/or training; or equivalent combination of education and experience, required. Minimum of 3-5 years of experience in a medical clinic setting or training in a hospital or corporate setting; must be highly computer literate, required. Two years of experience related to healthcare insurance verification and/or billing required. Approximately two to three years progressively more responsible related work experience necessary in order to gain in-depth understanding or organizational policies, procedures and operations, in order to assume a variety of high-level administrative details. Coding knowledge. Knowledge of clinical terminology. Understanding of patient treatment plans for purposes of obtaining authorizations. Ability to interpret RN or Physician notes in order to facilitate obtaining authorizations. Ability to evaluate & communicate to RN/Physician staff additional requirements or roadblocks. Additional coursework in business, computers or health care administration, preferred. Experience in a medical or surgical specialty clinic, preferred. Ability to interpret insurance records and related documentation. Current working knowledge of hospital operations, utilization management, case management, and managed care reimbursement, preferred. General understanding of revenue cycle with an emphasis on billing, coding, charge capture and reimbursement, preferred. Organizational and time management skills, as evidenced by capacity to prioritize multiple tasks and role components. Ability to work independently and exercise sound judgment in interactions with physicians, payors, and patients and their families if required. Strong oral and written communication skills required. Strong analytical and data management. Ability to work with all levels of management. Strong interpersonal communication and negotiation skills and experience interacting with clinicians and finance personnel.

EDUCATION/EXPERIENCE REQUIRED:

  • High school diploma or 3-5 years of related experience/training (or equivalent combination), required
  • Minimum 3-5 years of experience in a medical clinic setting or training in a hospital/corporate setting; must be highly computer literate, required
  • Minimum 2 years of experience in healthcare insurance verification and/or billing, required
  • 2-3 years of progressively responsible experience with organizational policies, procedures, and operations to handle high-level administrative responsibilities
  • Knowledge of coding and clinical terminology
  • Understanding of patient treatment plans for obtaining authorizations
  • Ability to interpret RN/Physician notes to facilitate authorizations
  • Ability to identify and communicate additional requirements or roadblocks to clinical staff
  • Ability to interpret insurance records and related documentation
  • Strong understanding of administrative workflows and healthcare processes

Preferred Qualifications:

  • Additional coursework in business, computers, or healthcare administration
  • Experience in a medical or surgical specialty clinic
  • Working knowledge of hospital operations, utilization management, case management, and managed care reimbursement
  • General understanding of the revenue cycle (billing, coding, charge capture, reimbursement)

Skills & Competencies:

  • Strong organizational and time management skills; ability to prioritize multiple tasks
  • Ability to work independently and exercise sound judgment
  • Strong oral and written communication skills
  • Strong analytical and data management skills
  • Ability to work with all levels of management
  • Strong interpersonal and negotiation skills, with experience interacting with clinicians and finance personnel
 
 
 
Additional Information
  • Organization: Corporate Services
  • Department: CBO Central Authorization Unit
  • Shift: Day Job
  • Union Code: Not Applicable

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