Care Access & Authorization Specialist

Wayne Health; Detroit (MI); Remote; USD 42,000 - 60,000; Full time

Job summary

Wayne Health is seeking a Referral and Authorization Coordinator in Detroit to support care delivery and revenue cycle. You will obtain pre-certifications, pre-authorizations, and schedule outpatient testing, while coordinating referrals and communicating with patients and providers.

Ideal candidates have 2-3 years in medical prior authorization or billing, strong ICD10/CPT knowledge, and excellent customer service skills to ensure timely and accurate documentation in the EMR.

Qualifications

• High School Diploma or equivalent required.
• 2–3 years insurance, medical prior authorization, billing or physician office experience.

Responsibilities

• Process referrals and submit medical records to insurance carriers to expedite prior authorization.
• Verify insurance eligibility and benefits with carriers.
• Schedule imaging and diagnostic appointments for patients.
• Request, track and obtain pre-authorizations from insurers.
• Document and communicate patient communications in the EMR.
• Manage referral repositories and ensure accuracy of information in the EMR.
• Follow up on authorizations and appeals as needed.
• Provide excellent customer service and handle inquiries via phone and email.

Skills

ICD10/CPT codes

Communication skills

Problem solving

Customer service

Education

High School Diploma or equivalent

Tools

Microsoft Outlook

Microsoft Teams

Microsoft Word

Excel

Job description

Wayne Health is seeking a Referral and Authorization Coordinator in Detroit to support care delivery and revenue cycle. You will obtain pre-certifications, pre-authorizations, and schedule outpatient testing, while coordinating referrals and communicating with patients and providers.

Ideal candidates have 2-3 years in medical prior authorization or billing, strong ICD10/CPT knowledge, and excellent customer service skills to ensure timely and accurate documentation in the EMR.