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.
The purpose of the Central Authorization Specialist position is to centrally facilitate the successful procuring of insurance authorizations for ordered procedures and post-operative care. This will be done through quality validations of obtained authorizations as well as continuous education and opportunity feedback to a multi-disciplinary team with the underlying objective of managing the cost of care and providing timely and accurate information to payors'. The Central Authorization Specialist helps drive change by identifying areas where performance improvement is needed (e.g., day to day workflow, education, process improvements, patient satisfaction). The Central Authorization Specialist is accountable for a designated caseload and plans effectively in order to meet demands and support resources procuring authorizations. Under general supervision and in accordance with established policies and procedures the specific functions within this role include: Subject matter expertise of precertification and payor authorization processes. Ensure successful authorizations are procured by ordering physician offices through validation of work effort and education of procuring staff. Ensure feedback relevant to successful authorization procurement is obtained from back end coding, billing and denial management resources and distributed to ordering physicians and authorization procurement staff to promote continuous improvement. Application of process improvement methodologies. The responsibilities includes acting as a centralized resource for assigned specialty across all sites of practice to ensure standardized and consistent procurement of authorizations.
Qualifications**REQUIRED QUALIFICATIONS:**
- High school diploma or equivalent; OR 3-5 years of related experience in a medical clinic, hospital, or corporate setting
- Minimum 3-5 years of experience in healthcare insurance verification and/or billing
- 2-3 years of progressively responsible related work experience in healthcare administration or revenue cycle operations
- Advanced computer literacy and proficiency with healthcare information systems
- Working knowledge of precertification and payor authorization processes
- Knowledge of medical coding and clinical terminology
- Ability to interpret clinical notes from RNs and physicians to facilitate authorization procurement
- Ability to evaluate and communicate authorization requirements and roadblocks to clinical and administrative staff
- Strong organizational and time management skills with demonstrated ability to prioritize multiple tasks
- Ability to work independently and exercise sound judgment in interactions with physicians, payors, and patients
- Strong oral and written communication skills
- Strong analytical and data management capabilities
- Ability to collaborate effectively with all levels of management and cross-functional teams
- Strong interpersonal communication and negotiation skills
**PREFERRED QUALIFICATIONS:**
- Additional coursework or certification in business, healthcare administration, or health information management
- Experience in a medical or surgical specialty clinic setting
- Ability to interpret insurance records and related documentation
- Current working knowledge of hospital operations, utilization management, and case management
- Understanding of managed care reimbursement models
- General understanding of revenue cycle with emphasis on billing, coding, charge capture, and reimbursement
- Experience interacting with clinicians and finance personnel in a healthcare setting
Skills Required
- High school diploma or equivalent, or 3-5 years of related experience in a medical clinic, hospital, or corporate setting
- 3-5 years of experience in healthcare insurance verification and/or billing
- 2-3 years of progressively responsible experience in healthcare administration or revenue cycle operations
- Advanced computer literacy and proficiency with healthcare information systems
- Working knowledge of precertification and payer authorization processes
- Knowledge of medical coding and clinical terminology
- Ability to interpret clinical notes from registered nurses and physicians
- Ability to evaluate and communicate authorization requirements and roadblocks
- Strong organizational and time management skills
- Ability to work independently and exercise sound judgment
- Strong oral and written communication skills
- Strong analytical and data management capabilities
- Ability to collaborate with management and cross-functional teams
- Strong interpersonal communication and negotiation skills
- Additional coursework or certification in business, healthcare administration, or health information management
- Experience in a medical or surgical specialty clinic
- Ability to interpret insurance records and related documentation
- Working knowledge of hospital operations, utilization management, and case management
- Understanding of managed care reimbursement models
- Understanding of revenue cycle, billing, coding, charge capture, and reimbursement
- Experience interacting with clinicians and finance personnel in healthcare
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.
