About Us
McLaren Health Care is a fully integrated health network committed to quality, evidence-based patient care with locations in Michigan and Indiana. The McLaren system includes 13 hospitals in Michigan, ambulatory surgery centers, imaging centers, a primary and specialty care physician network, commercial and Medicaid HMOs, home health, infusion and hospice providers, pharmacy services, a clinical laboratory network and a wholly owned medical malpractice insurance company. McLaren operates Michigan’s largest network of cancer centers and providers, anchored by the Karmanos Cancer Institute, one of only 53 National Cancer Institute-designated comprehensive cancer centers in the U.S.
Underpayment Specialist
Position Summary:
The Underpayment Specialist is responsible for performing audits of patient accounts to identify inaccurately under adjudicated accounts by the payer,and reconcile to the appropriate payer contract and corresponding explanation of benefits. Coordinates and reports audit outcomes as directed. Works closely with Revenue Cycle leadership and staff to identify process improvements that will allow payers to adjudicate claims per their associated contract. Underpayment Specialists will work with minimal direct supervision, reporting directly to the Patient Account Underpayment Manager of CBO Revenue Cycle.
Essential Functions and Responsibilities:
1. Under minimal direction, completes tasks accurately and timely. Seeks guidance and direction from leadership on tasks assigned.
2. Responds promptly, professionally and courteously to customers’ requests.
3. Cooperates and communicates effectively with all McLaren Health Care team members
4. Contributes to continuous quality improvement efforts.
5. Organizes time and prioritizes effectively.
6. Practices cost effective measures.
7. Maintains confidentiality in all matters regarding patients, the hospital, the department and human resources.
Qualifications
Minimum:
Associate degree required or equivalent combination of education and relevant experience may be acceptable
· Four years healthcare insurance billing experience; previous auditing experience preferred.
· Proven skills in Microsoft Office, specifically Excel and Word, Window based applications.
· Strong quantitative analytical and organization skills.
Equal Opportunity Employer
McLaren Health Care is an Equal Opportunity Employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sexual orientation, gender identification, age, sex, marital status, national origin, disability, genetic information, height or weight, protected veteran or other classification protected by law.
