Insurance Authorization & Care Access Specialist

Munson Healthcare Careers; Michigan; Hybrid; USD 42,000 - 56,000; Full time

Job summary

Munson Healthcare is seeking an Insurance Prior Authorization Specialist to help patients access care by navigating insurance requirements and obtaining authorizations. You will verify medical necessity, coordinate clinical reviews and appeals, and partner with providers, payers, and financial teams to remove barriers and keep services moving.

As part of a collaborative team, you will identify process improvements, educate teammates, and ensure work is completed accurately and efficiently with

Qualifications

• Associate’s degree in Health Services Administration or related field preferred; degree optional with 3 years revenue cycle experience.
• Successful completion of Medical Terminology and Anatomy courses required.
• Knowledge of current third-party payer reimbursement rules required.

Responsibilities

• Navigate insurance requirements to obtain authorizations.
• Verify medical necessity and coordinate clinical reviews and appeals.
• Partner with providers, payers, and clinical/financial teams to resolve barriers.
• Identify process improvements and educate team members; ensure work is accurate and efficient with patient experience in mind.

Skills

Revenue cycle experience

Payer rules knowledge

Medical terminology

Education

Associate’s degree in Health Services Administration or related field

Medical Terminology course

Anatomy course

Job description

Munson Healthcare is seeking an Insurance Prior Authorization Specialist to help patients access care by navigating insurance requirements and obtaining authorizations. You will verify medical necessity, coordinate clinical reviews and appeals, and partner with providers, payers, and financial teams to remove barriers and keep services moving.

As part of a collaborative team, you will identify process improvements, educate teammates, and ensure work is completed accurately and efficiently with