[Hiring] Insurance Prior Authorization Specialist @Munson Healthcare

Role Description

As an Insurance Prior Authorization Specialist, you will be focused on helping patients access the care they need by:

• Navigating insurance requirements
• Obtaining authorizations
• Verifying medical necessity
• Coordinating clinical reviews and appeals

You will partner closely with:

• Providers
• Payers
• Clinical and financial teams

Your responsibilities will include:

• Resolving barriers
• Managing changing priorities
• Keeping services moving forward
• Identifying process improvements
• Supporting and educating team members
• Ensuring work is completed accurately, efficiently, and with the patient experience in mind

Qualifications

• Associate’s degree in Health Services Administration or Business related field preferred
• In lieu of degree, 3 years internal revenue cycle experience will be considered, or one year internal insurance verifier
• Successful completion of Medical Terminology course and Anatomy course is required
• Knowledge of current third-party payer reimbursement rules required

Requirements

• Minimum productivity requirements
• Peer review process are required

Benefits

• Tuition reimbursement
• In-person and online development
• Access to our career hub to help you advance
• Full benefits
• Paid holidays
• Generous PTO
• Employee discounts
• Free individual retirement counseling
• Free wellness platform for you and your family
• Personalized support for personal or family challenges
• Opportunities to share ideas through improvement huddles, employee surveys, and town hall meetings

Company Description

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.