Job Summary

Ensures that timely, accurate and complete data is submitted to appropriate insurance companies to guarantee prompt payments to Spectrum Health. Communicates and collaborates with the multidisciplinary team through verbal and written communication. Participates with Care Team for the integration of the patient to the home or transitional environment by developing, planning, implementing and evaluating in accordance with current existing federal, state and local standards. Adheres to confidentiality policies specific to communications, patient confidentiality, record keeping and coordination services.

Essential Functions

• Inputs data from various sources (insurance companies, admissions, certification, and other hospitals) into Care Management discharge planning software and insures communication to members of Care Team.
• Processes and prepares clinical reviews completed by Care Management Department (CMD) employees for confidential transmission to third party payers.
• Maintains ongoing communication between Spectrum Health (SH) and third party payers related to the number of hospital days authorized, additional requests for clinical information, anticipated discharge needs, etc.
• Supports specific third party payers by obtaining authorization for services; providing accurate & timely admission/discharge dates; updating CMD and SH employees on any demographic changes; problem solving issues/concerns third party payer may have. Reports reviews needed to case manager.

How Corewell Health cares for you

• Comprehensive benefits package to meet your financial, health, and work/life balance goals. Learn more here.
• On-demand pay program powered by Payactiv
• Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more!
• Optional identity theft protection, home and auto insurance, pet insurance
• Traditional and Roth retirement options with service contribution and match savings

Qualifications

Required

• High School Diploma or equivalent
• 2 years of relevant experience Related work in a clinical office or health insurance setting
• Working in an organization of size and complexity comparable to Spectrum Health Required

Preferred

• Associate's Degree Business Administration, Management, Commerce, Communications, Public Relations or other related degree or equivalent combination of education and experience

About Corewell Health

As a team member at Corewell Health, you will play an essential role in delivering personalized health care to our patients, members and our communities. We are committed to cultivating and investing in YOU. Our top-notch teams are comprised of collaborators, leaders and innovators that continue to build on one shared mission statement - to improve health, instill humanity and inspire hope. Join a nationally recognized health system with an ambitious vision of continued advancement and excellence.

Primary Location

SITE - Butterworth Hospital - 100 Michigan St - Grand Rapids

Department Name

Care Management - Butterworth

Employment Type

Part time

Shift

Day (United States of America)

Weekly Scheduled Hours

0.04

Hours of Work

8:00 a.m.- 4:30 p.m.

Days Worked

Monday to Friday

Weekend Frequency

N/A

CURRENT COREWELL HEALTH TEAM MEMBERS – Please apply through Find Jobs from your Workday team member account. This career site is for Non-Corewell Health team members only.

Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief.

Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.

An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team.

You may request assistance in completing the application process by calling 616.486.7447.