Central Authorization Specialist

Posted Yesterday
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Hiring Remotely in Troy, MI, USA
In-Office or Remote
Mid level
Healthtech
The Role
Obtains and validates insurance authorizations for procedures and postoperative care. Advises physician offices and procurement staff on precertification and payer processes, manages authorization caseloads, communicates coding and denial-management feedback, and identifies workflow and process improvements. Requires healthcare authorization or billing experience, knowledge of coding and clinical terminology, and strong organizational and communication skills.
Summary Generated by Built In
Company Description

At Henry Ford Health, we're committed to advancing health and improving lives for the millions of people we serve across Michigan and around the world. As one of the nation's leading academic health systems, we provide a comprehensive continuum of care that includes primary and preventive services, specialty and complex care, virtual care, pharmacy, home health, eye care, health insurance, and more. With 12 hospitals and hundreds of ambulatory care locations, including former Ascension Southeast Michigan and Flint Region facilities, our growing network expands access to exceptional care in the communities we serve.

Headquartered in Detroit, Henry Ford Health is helping shape the future of healthcare through the transformative Future of Health: Detroit initiative, a $3 billion investment that is redefining our academic healthcare campus and advancing innovation, research, education, and community impact.

Our work is grounded in purpose, collaboration, and belonging. We empower team members to grow their careers, contribute innovative ideas, and make a meaningful difference every day. Whether you're caring for patients, supporting operations, conducting research, or driving new solutions, you'll be part of a team united by a shared mission: delivering exceptional care, advancing health outcomes, and building healthier communities for all.

Job Description

The Central Authorization Specialist serves as a centralized resource to facilitate the successful procurement of insurance authorizations for ordered procedures and post-operative care. Key responsibilities include:

  • Validate obtained authorizations and ensure quality standards are met across all sites of practice
  • Provide subject matter expertise in precertification and payor authorization processes to ordering physician offices and procurement staff
  • Collect feedback from back-end coding, billing, and denial management resources and distribute findings to ordering physicians and authorization procurement staff to promote continuous improvement
  • Manage an assigned caseload while planning effectively to meet demands and support authorization procurement efforts
  • Identify performance improvement opportunities in workflow, education, and processes to drive organizational change and manage cost of care
  • Apply process improvement methodologies to standardize and enhance authorization procurement procedures

All functions are performed under general supervision and in accordance with established organizational policies and procedures.

Qualifications

**QUALIFICATIONS**

**Required:**

  • High school diploma or equivalent; minimum 3-5 years of related experience in a medical clinic, hospital, or corporate healthcare setting
  • Minimum 2 years of experience in healthcare insurance verification and/or billing
  • Proficiency with computer systems and healthcare software applications
  • Knowledge of medical coding, clinical terminology, and patient treatment plans
  • Ability to interpret clinical notes and insurance documentation
  • Strong organizational and time management skills with ability to prioritize multiple tasks
  • Excellent written and oral communication skills
  • Ability to work independently and exercise sound judgment with physicians, payors, and patients

**Preferred:**

  • Experience in a medical or surgical specialty clinic
  • Knowledge of hospital operations, utilization management, and managed care reimbursement
  • Understanding of revenue cycle processes including billing, coding, and reimbursement
  • Additional coursework in business, healthcare administration, or related field
  • Experience with process improvement methodologies

Skills Required

  • High school diploma or equivalent
  • 3-5 years of related experience in a medical clinic, hospital, or corporate healthcare setting
  • At least 2 years of experience in healthcare insurance verification and/or billing
  • Proficiency with computer systems and healthcare software applications
  • Knowledge of medical coding, clinical terminology, and patient treatment plans
  • Ability to interpret clinical notes and insurance documentation
  • Strong organizational and time management skills
  • Ability to prioritize multiple tasks
  • Excellent written and oral communication skills
  • Ability to work independently and exercise sound judgment with physicians, payers, and patients
  • Experience in a medical or surgical specialty clinic
  • Knowledge of hospital operations, utilization management, and managed care reimbursement
  • Understanding of revenue cycle processes, including billing, coding, and reimbursement
  • Additional coursework in business, healthcare administration, or a related field
  • Experience with process improvement methodologies
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The Company
50,000 Employees
Year Founded: 1915

What We Do

Henry Ford Health is a Detroit-headquartered academic healthcare system serving more than 2 million people across Michigan and beyond. Its integrated offerings include primary, preventive, urgent, specialty, home, and virtual care, health insurance, pharmacy, and eye care. The organization also advances clinical innovation, research, clinical trials, medical education, community health, health equity, and services for vulnerable communities throughout the region.

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