Central Authorization Specialist

Posted 2 Days Ago
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Hiring Remotely in Troy, MI, USA
In-Office or Remote
Mid level
Healthtech
The Role
Procures and validates insurance authorizations for procedures and postoperative care. Provides expertise on precertification and payer authorization processes, coordinates with physicians and authorization teams, identifies workflow and performance gaps, and promotes standardized practices across specialty sites. Manages authorization caseloads while interpreting clinical documentation, communicating requirements, and collaborating with coding, billing, denial management, finance, clinicians, payers, and patients.
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

**Central Authorization Specialist - Responsibilities**

**- MI Residents Only -**

  • Procure and validate insurance authorizations for ordered procedures and post-operative care in accordance with established policies and procedures
  • Provide subject matter expertise in precertification and payor authorization processes to ordering physician offices and authorization procurement staff
  • Gather feedback from back-end coding, billing, and denial management resources and distribute findings to ordering physicians to promote continuous improvement
  • Apply process improvement methodologies to identify and address performance gaps in authorization procurement workflows, education, and patient satisfaction
  • Serve as a centralized resource across all practice sites to ensure standardized and consistent authorization procurement for assigned specialty
  • Manage designated caseload and plan effectively to meet authorization procurement demands

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 a medical clinic setting
  • Two years of healthcare insurance verification and/or billing experience
  • Two to three years of progressively responsible related work experience
  • High level of computer literacy
  • Knowledge of clinical terminology and coding
  • Understanding of patient treatment plans for authorization purposes
  • Ability to interpret RN or Physician notes to facilitate authorization procurement
  • Ability to evaluate and communicate additional requirements or roadblocks to RN/Physician staff
  • Strong organizational and time management skills with ability to prioritize multiple tasks
  • Ability to work independently and exercise sound judgment with physicians, payors, and patients
  • Strong oral and written communication skills
  • Strong analytical and data management capabilities
  • Ability to work effectively with all levels of management
  • Strong interpersonal communication and negotiation skills

PREFERRED:

  • Additional coursework in business, computers, or healthcare administration
  • Experience in a medical or surgical specialty clinic
  • Ability to interpret insurance records and related documentation
  • Current working knowledge of hospital operations, utilization management, and case management
  • Knowledge of managed care reimbursement processes
  • General understanding of revenue cycle with emphasis on billing, coding, charge capture, and reimbursement
  • Experience interacting with clinicians and finance personnel

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 a medical clinic setting
  • Two years of healthcare insurance verification and/or billing experience
  • Two to three years of progressively responsible related work experience
  • High level of computer literacy
  • Knowledge of clinical terminology and coding
  • Understanding of patient treatment plans for authorization purposes
  • Ability to interpret RN or physician notes
  • Ability to evaluate and communicate authorization requirements or 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 work effectively with all levels of management
  • Strong interpersonal communication and negotiation skills
  • Additional coursework in business, computers, or healthcare administration
  • 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
  • Knowledge of managed care reimbursement processes
  • General understanding of revenue cycle, billing, coding, charge capture, and reimbursement
  • Experience interacting with clinicians and finance personnel
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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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