PATIENT AUTHORIZATION AND DENIALS SPECIALIST

Trinity Health; United States; On-site; USD 29,000 - 44,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Prescription drug coverage

Retirement savings with employer match

Paid time off

Tuition reimbursement

Life and AD&D insurance

Well-being initiative

Career growth opportunities

Job summary

Trinity Health Of New England is seeking an on-site healthcare authorization specialist to review information for hospital reimbursements. You will handle authorizations, support denial cases, and work with analytics to improve processes within Case Management.

The role requires an on-site presence, with 40-hour weeks, and benefits starting day one. Relevant healthcare experience and strong customer service are essential for success.

Qualifications

• Associate degree plus 1–2 years of healthcare experience or a high school diploma/GED with 5+ years in healthcare.
• Medical billing or insurance authorization experience is preferred.
• Excellent customer service and professional communication are required.

Responsibilities

• Authorize and manage denials within Case Management to ensure inpatient admissions are properly authorized.
• Identify, report, and resolve issues stemming from authorization and denial processes.
• Support the Case Management Utilization Coordinator team with data, reports, and analytics.
• Develop and implement strategies to optimize authorization and denial processes for revenue integrity.

Skills

Customer service

Professional communication

Healthcare experience

Medical billing

Insurance authorization

Education

Associate degree

High school diploma/GED

Job description

Employment Type: Full time Shift: Day Shift Description: Position is on site, local residency required

Position Purpose

This position is responsible for reviewing financial/insurance information obtained to meet State, Federal and Third-Party billing requirements to ensure reimbursement for services.

What you will do

• Responsible for authorization and denials within Case Management ensuring appropriate authorization for inpatient hospital admissions.
• Assists in the identification, reporting and resolution of any issues stemming from or with authorization and denial processes.
• Supports the needs of the Case Management Utilization Coordinator team using data, system reports, and analytics.
• Develops and Implements strategies to optimize all aspects of authorization and denials supporting hospital revenue integrity team through a comprehensive approach.

Minimum Qualifications

• Associate degree and one to two (1 – 2) years of healthcare experience required, or, in lieu of an Associate degree, a high school diploma/GED and five (5) or more years of healthcare experience will be considered.
• Medical billing or insurance authorization experience preferred.
• Excellent customer service skills and the ability to communicate professionally required.

Pay Range

Pay Range: $21.35 - $32.05 per hour Pay is based on experience, skills, and education. Exempt positions under the Fair Labor Standards Act (FLSA) will be paid within the base salary equivalent of the stated hourly rates. The pay range may also vary within the stated range based on location.

At Trinity Health Of New England, we understand that the success of our organization is directly related to our hardworking, compassionate, and dedicated colleagues who contribute their time and skills to help transform healthcare. That's why we've compiled a competitive, comprehensive compensation and benefits package that offers our colleagues protection and peace of mind, both at home and at work.

Benefits

• Medical, Dental, Prescription Drug and Vision Coverage
• Retirement Savings Program with Employer Match
• Time Off - may include Paid Time Off, Vacation, Sick Time and Holidays
• Tuition Reimbursement and Professional Development Opportunities
• Basic and Supplemental Life and AD&D Insurance
• Well-being Initiative
• Career Growth and Advancement Opportunities within Trinity Health

Position Highlights and Benefits

Full time 40-hour week - includes every other weekend and rotating Holidays. Pay Differentials will apply! Position is on site, local residency required Great benefits and Health Insurance Coverage - Day 1.

Day 1 Ministry/Facility Information

Trinity Health Of New England is an integrated health care delivery system that is comprised of world-class providers and facilities dedicated to full spectrum preventative, acute, and post-acute care. We aim to deliver top level care to increase our community's overall health at lower costs. While we serve nearly 3 million people, we are proud to be a part of a national system that focuses on putting our patients first and having the best colleagues to do so.

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care.

We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.

Trinity Health is one of the largest not-for-profit, faith-based health care systems in the nation. Together, we’re 121,000 colleagues and nearly 36,500 physicians and clinicians caring for diverse communities across 27 states. Nationally recognized for care and experience, our system includes 101 hospitals, 126 continuing care locations, the second largest PACE program in the country, 136 urgent care locations, and many other health and well-being services.

Based in Livonia, Michigan, in fiscal year 2023, we invested $1.5 billion in our communities through charity care and other community benefit programs. For more information, visit http://www.trinity-health.org. You can also follow Trinity Health on LinkedIn.