PATIENT AUTHORIZATION AND DENIALS SPECIALIST PD

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

Benefits offered by this job

Medical coverage

Dental coverage

Prescription drug coverage

Vision coverage

Retirement match

Paid time off & holidays

Tuition reimbursement

Life & AD&D insurance

Well-being program

Career growth opportunities

Job summary

SaintFrancis Hospital, part of Trinity Health Of New England, is seeking a case management professional to optimize authorization and denials for inpatient admissions. You will review billing information, support the Utilization Coordinator team with data, and ensure compliance with state and federal requirements.

The role emphasizes analytical skills, customer service, and collaboration across departments.

Qualifications

• Associate degree with 1–2 years healthcare experience.
• Or HS diploma/GED with 5+ years healthcare experience.
• Medical billing or insurance authorization experience preferred.
• Excellent customer service and professional communication required.

Responsibilities

• Authorize inpatient admissions and manage denials.
• Identify and resolve issues in authorization/denial processes.
• Support Utilization Coordinator team with data and analytics.
• Develop and implement strategies to optimize authorization/denial processes.

Skills

Customer service

Professional communication

Education

Associate degree

HS diploma + 5+ years healthcare experience

Job description

Employment Type: Part time

Shift: Day Shift

Description: Come join our team in Case Management at SaintFrancis Hospital, a member of Trinity Health Of New England!

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

Position Highlights and Benefits

Per diem 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.

• 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

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.