Insurance and Prior Authorization Specialist

This is a fully remote position, open to applicants in Michigan.

📋 Description

• Navigate insurance requirements

• Secure prior authorizations

• Verify the necessity of medical services

• Coordinate clinical reviews and manage appeals

• Collaborate with providers, payers, and both clinical and financial teams

• Overcome barriers and adapt to changing priorities

• Maintain momentum in service delivery

• Identify opportunities for process enhancements

• Provide support and education to team members

• Ensure tasks are completed accurately and efficiently, prioritizing the patient experience

⛳️ Requirements

• Must be a resident of Michigan

• Preferred: Associate’s degree in Health Services Administration or a related Business field

• In absence of a degree, 3 years of internal revenue cycle experience will be taken into account

• Alternatively, one year of experience as an internal insurance verifier

• Must meet minimum productivity standards

• Participate in the peer review process

• Successful completion of a Medical Terminology course is required

• Successful completion of an Anatomy course is required

• Knowledge of current reimbursement rules from third-party payers is essential

• All employees must be vaccinated or possess lab-confirmed immunity for Measles, Mumps, Rubella, and Varicella

• All employees must receive a flu vaccine during the flu season in the year of hiring and annually thereafter, or obtain an approved medical or religious exemption

🏝️ Benefits

• Tuition reimbursement

• Opportunities for both in-person and online development

• Access to a career hub

• Comprehensive benefits package

• Paid holidays

• Generous paid time off (PTO)

• Employee discounts

• Complimentary individual retirement counseling

• Free wellness platform available for you and your family

• Personalized assistance for personal or family challenges